Skip to main content
Kent Academic Repository

Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial

Stephens, G., Littlewood, C., Foster, N.E., Dikomitis, Lisa (2020) Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial. Clincial Rehabilitation, 35 (6). pp. 911-919. ISSN 0269-2155. (doi:10.1177/0269215520984025) (KAR id:98454)


Objective: To investigate acceptability, barriers to adherence with the interventions, and which outcome measures best reflect the participants’ rehabilitation goals in a pilot and feasibility randomised controlled trial evaluating early patient-directed rehabilitation and standard rehabilitation, including sling immobilisation for four weeks, following surgical repair of the rotator cuff of the shoulder. Design: Nested qualitative study. Setting: Five English National Health Service Hospitals. Subjects: Nineteen patient participants who had undergone surgical repair of the rotator cuff and 10 healthcare practitioners involved in the trial. Method: Individual semi-structured interviews. Data were analysed thematically. Results: Four themes: (1) Preconceptions of early mobilisation; many participants were motivated to enter the trial for the opportunity of removing their sling and getting moving early. (2) Sling use and movement restrictions; for some, sling use for four weeks was unacceptable and contributed to their pain, rather than relieving it. (3) Tensions associated with early mobilisation; clinical tensions regarding early mobilisation and the perceived risk to the surgical repair were apparent. (4) Processes of running the trial; participants found the trial processes to be largely appropriate and acceptable, but withholding the results of the post-operative research ultrasound scan was contentious. Conclusion: Trial processes were largely acceptable, except for withholding results of the ultrasound scan. For some participants, use of the shoulder sling for a prolonged period after surgery was a reported barrier to standard rehabilitation whereas the concept of early mobilisation contributed tension for some healthcare practitioners due to concern about the effect on the surgical repair.

Item Type: Article
DOI/Identification number: 10.1177/0269215520984025
Uncontrolled keywords: physical therapy, Qualitative study, rehabilitation, shoulder pain, adult, clinical trial, controlled study, diagnostic imaging, echography, human, immobilization, male, mobilization, multicenter study, postoperative period, procedures, psychology, qualitative research, randomized controlled trial, rotator cuff, rotator cuff injury, surgery, Adult, Early Ambulation, Humans, Immobilization, Male, Postoperative Period, Qualitative Research, Rotator Cuff, Rotator Cuff Injuries, Ultrasonography
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: National Institute for Health Research (
Depositing User: Manfred Gschwandtner
Date Deposited: 30 Nov 2022 17:32 UTC
Last Modified: 04 Mar 2024 17:16 UTC
Resource URI: (The current URI for this page, for reference purposes)

University of Kent Author Information

  • Depositors only (login required):

Total unique views for this document in KAR since July 2020. For more details click on the image.