Evidence map›Paper›PMID 38580365›Full record

ArticleBMJ open2024

Clinical and cost-effectiveness of individualised (early) patient-directed rehabilitation versus standard rehabilitation after surgical repair of the rotator cuff of the shoulder: protocol for a multicentre, randomised controlled trial with integrated Quintet Recruitment Intervention (RaCeR 2).

Bruno Mazuquin, Maria Moffatt, Alba Realpe, Rachelle Sherman, Katie Ireland, Zak Connan, Jack Tildsley, Andrea Manca, Vijay Singh Gc, Nadine E Foster and 6 more

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 11 institutions in 2 countries.

Bruno MazuquinHealth Professions, Manchester Metropolitan University, Manchester, UK b.mazuquin@mmu.ac.uk.ORCID 0000-0003-1566-9551
Maria MoffattSchool of Allied Health Professios and Nursing, University of Liverpool, Liverpool, UK.
Alba RealpePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-9502-3907
Rachelle ShermanDerby Clinical Trials Support Unit, Royal Derby Hospital, Derby, UK.
Katie IrelandDerby Clinical Trials Support Unit, Royal Derby Hospital, Derby, UK.
Zak ConnanDerby Clinical Trials Support Unit, Royal Derby Hospital, Derby, UK.
Jack TildsleyDerby Clinical Trials Support Unit, Royal Derby Hospital, Derby, UK.
Andrea MancaCentre for Health Economics, York University, York, UK.ORCID 0000-0001-8342-8421
Vijay Singh GcSchool of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.ORCID 0000-0003-0365-2605
Nadine E FosterSTARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Saint Lucia, Queensland, Australia.
Jonathan ReesNuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Steven DrewUniversity Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.
Marcus BatemanDerby Shoulder Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.ORCID 0000-0002-3203-506X
Apostolos FakisDerby Clinical Trials Support Unit, Royal Derby Hospital, Derby, UK.
Malin FarnsworthPatient and Public Involvement Representative, England, UK.
Chris LittlewoodAllied Health, Social Work & Wellbeing, Faculty of Health Social Care and Medicine, Edge Hill University, Ormskirk, UK.ORCID 0000-0002-7703-727X
Royal Derby Hospital · GBEdge Hill University · GBManchester Metropolitan University · GBNuffield Orthopaedic Centre · GBThe University of Queensland · AUUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity Hospitals Coventry and Warwickshire NHS Trust · GBUniversity Hospitals of Derby and Burton NHS Foundation Trust · GBUniversity of Huddersfield · GBUniversity of Liverpool · GBUniversity of York · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite the high number of operations and surgical advancement, rehabilitation after rotator cuff repair has not progressed for over 20 years. The traditional cautious approach might be contributing to suboptimal outcomes. Our aim is to assess whether individualised (early) patient-directed rehabilitation results in less shoulder pain and disability at 12 weeks after surgical repair of full-thickness tears of the rotator cuff compared with current standard (delayed) rehabilitation. METHODS AND ANALYSIS: The rehabilitation after rotator cuff repair (RaCeR 2) study is a pragmatic multicentre, open-label, randomised controlled trial with internal pilot phase. It has a parallel group design with 1:1 allocation ratio, full health economic evaluation and quintet recruitment intervention. Adults awaiting arthroscopic surgical repair of a full-thickness tear are eligible to participate. On completion of surgery, 638 participants will be randomised. The intervention (individualised early patient-directed rehabilitation) includes advice to the patient to remove their sling as soon as they feel able, gradually begin using their arm as they feel able and a specific exercise programme. Sling removal and movement is progressed by the patient over time according to agreed goals and within their own pain and tolerance. The comparator (standard rehabilitation) includes advice to the patient to wear the sling for at least 4 weeks and only to remove while eating, washing, dressing or performing specific exercises. Progression is according to specific timeframes rather than as the patient feels able. The primary outcome measure is the Shoulder Pain and Disability Index total score at 12-week postrandomisation. The trial timeline is 56 months in total, from September 2022. TRIAL REGISTRATION NUMBER: ISRCTN11499185.

Indexed as

Rotator CuffRotator Cuff InjuriesAdultArthroscopyCost-Benefit AnalysisHumansMulticenter Studies as TopicPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicShoulderShoulder PainTreatment Outcomeorthopaedic & trauma surgeryphysical therapy modalitiesrandomized controlled trialshoulder

Identifiers

PMID38580365
PMCPMC11002397
OpenAlexW4393989915

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.