Supervised Physiotherapy vs Home Exercise After Rotator Cuff Repair: A Meta-Analysis.

Abstract

Objective To compare supervised physiotherapy with structured home exercise programs after rotator cuff repair as rehabilitation delivery strategies, evaluating their relative effectiveness on postoperative pain, functional outcomes, and shoulder range of motion. Data sources A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was conducted through November 2025 to identify clinical studies comparing supervised physiotherapy with home-based rehabilitation after rotator cuff repair. Study selection Six studies met the inclusion criteria. Eligible studies compared supervised physiotherapy with home exercise programs and reported postoperative outcomes, including pain scores, functional measures, and shoulder range of motion (ROM). Data extraction Extracted outcomes included visual analog scale (VAS) pain, functional scores such as subjective shoulder value, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and ROM parameters (external rotation and forward flexion). Mean differences (MD) with 95% CIs were pooled where appropriate. Data synthesis Postoperative pain showed no significant difference between supervised physiotherapy and home exercise programs (P=.41). No statistically significant differences were identified in functional outcomes, including subjective shoulder value (P=.73), ASES (P=.07), or Constant-Murley score (P=.27). External rotation ROM was comparable between groups (P=.50), whereas forward flexion demonstrated a statistically significant advantage in favor of supervised physiotherapy (MD=5.87°, 95% CI, 2.92-8.81; P Conclusions Supervised physiotherapy did not demonstrate superior pain reduction compared with structured home exercise programs after rotator cuff repair. Functional outcomes were comparable between delivery models, while supervised physiotherapy showed a modest advantage in forward flexion ROM. Structured home rehabilitation represents a safe and effective alternative for many patients, although supervised therapy may be appropriate for individuals requiring closer monitoring or at increased risk of postoperative stiffness. Further standardized, long-term studies are needed to refine patient selection and optimize rehabilitation strategies.