Patients six months after arthroscopic rotator cuff repair exhibit increased thoracic kyphosis compared to healthy individuals despite standard rehabilitation protocol

Abstract

Background

Shoulder pain is often accompanied by disturbances in spinal posture, such as increased thoracic kyphosis. Moreover, a high prevalence of scapular dyskinesis has been observed in the majority of shoulder pain patients. However, these alterations seen in individuals with shoulder pain have not been thoroughly examined after arthroscopic rotator cuff repair (RCr).

Objective

To investigate alterations in spinal alignment and mobility, shoulder range of motion, and scapular dyskinesis (SD), to determine whether differences exist between patients with RCr and healthy individuals.

Methods

The study included 26 participants who had undergone RCr (the RCr group) and 29 healthy individuals (the healthy group). The Spinal Mouse device (IDIAG-M360) was utilized to measure spinal alignment (thoracic kyphosis, lumbar lordosis, sacral-hip angles, and pelvic inclination), and spinal mobility. The study also evaluated the presence of scapular dyskinesia (SD), and shoulder range of motion (ROM) using the observational SD test and a universal goniometer, respectively. All variables were compared between the groups.

Results

The RCr group had an increased mean thoracic kyphosis compared to the healthy group (p = 0.033). However, no significant differences in spinal mobility were observed between the groups (p > 0.05). The results from the scapular dyskinesia analysis revealed considerable variations between the groups (p = 0.001). Among shoulder ROM variables, only external rotation was reduced in the RCr group (p = 0.003). Further subgroup analysis based on trauma status revealed that individuals with non-traumatic rotator cuff tear exhibited an increased thoracic kyphosis angle (p = 0.037).

Conclusions

RCr patients exhibited an increased thoracic kyphosis angle and an increased presence of SD, despite showing similar spinal mobility when compared to healthy individuals. These findings may necessitate further research investigating the effectiveness of thoracic mobilization techniques and targeted strengthening exercises aimed at mitigating the increased thoracic kyphosis angle and SD observed in patients undergoing rehabilitation following RCr.