protocol

Here I attach the Delphi questionnaire for the protocol validation: "Protocol of early, intensive and complementary aquatic rehabilitation post arthroscopic surgical suture of the rotator cuff".

The main purpose of this protocol is to improve early mobility of the glenohumeral joint after an arthroscopic surgical intervention of the rotator cuff.

The protocol effectiveness evaluation, once validated through the aforementioned Delphi study, will be performed through a clinical trial with patients from the Hospital Universitari de Vic-Consorci Hospitalari de Vic (CHV).

To create the protocol, I have taken into consideration different aspects:
1. Water physical characteristics: hydrostatic pressure (buoyancy) and the hydrodynamic aspects. These features allow an easier glenohumeral joint movement, letting a more practical work in the three spatial planes.
2. Early and intensive rehabilitation will allow to gain joint balance faster. Consequently, we will be able to avoid the stiffness that appears after some surgical sutures of the rotator cuff.
3. Water sessions will have a longer work duration in comparison to other used protocols. This will let us achieve a joint balance improvement in the early stages.
4. Security for the sutures’ integrity. Electromyographical activity in the water is lower than in conventional groundwork; besides making the suggested exercises always within the no-pain rule.
The proposed protocol lasts 3 weeks in total, with 6 work sessions a week. These 6 weekly sessions will be distributed as follows: 4 water sessions plus 2 conventional ground recovery sessions in the same hospital. Moreover, the sessions in the aquatic environment will last 45 minutes, while the sessions in the rehabilitation services of the hospital will last as established by the same institution. Thus, there will be 12 water sessions and 6 sessions in the hospital rehabilitation services in total.

The protocol is expected to begin 2 weeks after the surgery, according to the surgeon and the rehabilitation physician assessments.

Water sessions will be conducted and supervised by the physiotherapist developing the study (myself). Therefore, the sessions that will be held in the same hospital will follow the guidelines of the established protocol of the hospital. Besides, the physiotherapists of the hospital as well as the rehabilitation doctor will supervise the sessions. Bear in mind that it is a complementary work.

The results will be assessed using the Constant Score.

See below to find the protocol summarized in a schematic chart:

Biblio

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Wells, S., Schilz, J., Uhl, T., & Gurney, A. (2016). A Literature Review of Studies Evaluating Rotator Cuff Activation during Early Rehabilitation Exercises for Post-Op Rotator Cuff Repair. Journal of Exercise Physiologyonline.

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