JSES - 2026-07-15 - Journal Article
Early EMG-based Low Supraspinatus Activity Exercises After Arthroscopic Repair of Medium-Sized Rotator Cuff Tears: A Randomized Controlled Trial.
Kuş G, Çelik D, Atalar AC
Topics
Key Takeaway
EMG-guided early rehabilitation starting at 1 week post-repair reduced night pain by 2.56 points and activity pain by 2.73 points (both exceeding MCID) at 4 weeks versus 4-week immobilization, with no difference in any outcome at 12 months.
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Summary
This RCT compared EMG-guided low supraspinatus-load exercises initiated at 1 week postoperatively versus 4-week immobilization in 30 patients after arthroscopic repair of full-thickness medium-sized rotator cuff tears. Group I demonstrated significantly lower VAS pain scores at 4 weeks (night pain mean difference 2.56, activity pain mean difference 2.73, both exceeding MCID). At 12 months, ROM, strength, Constant-Murley Score, SF-36, and Global Rating of Change were equivalent between groups.
Key Limitation
The study is underpowered at n=30 and does not report structural retear rates via postoperative imaging, making it impossible to confirm that equivalent functional outcomes reflect equivalent tendon healing rather than compensatory mechanisms.
Original Abstract
BACKGROUND
Postoperative rehabilitation after arthroscopic rotator cuff repair remains controversial because early mobilization may compromise tendon healing and increase re-tear risk, leading many clinicians to prefer prolonged immobilization. Exercises associated with low supraspinatus muscle activity may enable earlier rehabilitation while minimizing stress on the repaired tendon. The aim of this study to investigate the effects of an electromyography (EMG) based early rehabilitation program consisting of low supraspinatus muscle activity exercises compared with a four-week immobilization protocol following arthroscopic repair of full-thickness, medium-sized rotator cuff tears.
METHODS
Thirty patients who underwent arthroscopic repair of full-thickness, medium-sized rotator cuff tears were randomly assigned to an early rehabilitation group (Group I) or an immobilization group (Group II). Group I initiated EMG-based low supraspinatus activity exercises one week postoperatively for three weeks, while Group II remained immobilized for four weeks. From week 4 onward, both groups followed an identical standardized rehabilitation program until week 12. Outcomes included pain (VAS), shoulder range of motion, muscle strength, function (Constant-Murley Score), quality of life (SF-36), and patient satisfaction (Global Rating of Change), assessed over a 12-month follow-up period.
RESULTS
At four weeks postoperatively, Group I reported significantly less night pain (mean difference=2.56, p=.018) and pain during activity (mean difference = 2.73, p=.001) than Group II, with both reductions exceeding the minimal clinically important difference (MCID). At long-term follow-up, no significant differences were observed between groups in range of motion, muscle strength, shoulder function, quality of life, or patient satisfaction.
CONCLUSION
An EMG-based early rehabilitation using low supraspinatus-load exercises offers clinically important short-term pain benefits without impairing long-term results after arthroscopic repair of medium rotator cuff tears. This approach appears to be a safe substitute for postoperative immobilization, especially when early pain control is a priority.