Massive rotator cuff tears are associated with significant pain, functional limitations, and prolonged rehabilitation following surgical repair. In the early postoperative phase, rehabilitation protocols are often limited due to surgical protection requirements, which may delay the restoration of motor control and shoulder function. Graded motor imagery (GMI), a movement representation technique that includes laterality recognition, motor imagery, and mirror therapy, has been shown to modulate cortical processing and improve pain and motor function in various musculoskeletal and neurological conditions. However, its potential role in early postoperative shoulder rehabilitation has not been adequately investigated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
38
The graded motor imagery program will include laterality recognition training, motor imagery exercises, and mirror therapy tasks aimed at activating cortical motor networks without physical shoulder movement during the early postoperative phase.
Pain Intensity (Numeric Rating Scale, NRS)
Pain intensity will be assessed using the Numeric Rating Scale (NRS), where participants rate their average shoulder pain over the past 24 hours on a scale from 0 (no pain) to 10 (worst imaginable pain). Pain will be evaluated at rest, during activity, and at night.
Time frame: Baseline (postoperative day 0), 2 weeks, 4 weeks, 6 weeks, and 12 weeks after surgery.
Subjective Shoulder Value (SSV)
Participants will rate the overall function of their shoulder on a 10-cm scale ranging from "as bad as it could be" to "as good as it could be."
Time frame: Baseline (postoperative day 0), 2 weeks, 4 weeks, 6 weeks, and 12 weeks.
Passive Shoulder Range of Motion
Passive shoulder range of motion will be measured using a goniometer.
Time frame: 4 weeks, 6 weeks, and 12 weeks after surgery.
Shoulder Pain and Disability Index (SPADI)
The Shoulder Pain and Disability Index (SPADI) is a self-reported questionnaire consisting of pain (5 items) and disability (8 items) subscales. Scores range from 0 to 100, with higher scores indicating greater pain and functional limitation.
Time frame: 6 weeks and 12 weeks after surgery.
Motor Imagery Ability (VMIQ-2)
Motor imagery ability will be evaluated using the Vividness of Movement Imagery Questionnaire-2 (VMIQ-2), which assesses internal visual imagery, external visual imagery, and kinesthetic imagery across 36 items. Lower scores indicate more vivid imagery ability.
Time frame: Baseline (postoperative day 0), 6 weeks, and 12 weeks.
Tampa Scale of Kinesiophobia (TSK)
The Tampa Scale of Kinesiophobia evaluates fear of movement related to pain. Scores range from 17 to 68, with higher scores indicating greater fear of movement.
Time frame: Baseline (postoperative day 0), 6 weeks, and 12 weeks.
Pain Catastrophizing Scale (PCS)
The PCS assesses catastrophic thinking related to pain across 13 items. Total scores range from 0 to 52, with higher scores indicating greater catastrophizing.
Time frame: Baseline (postoperative day 0), 6 weeks, and 12 weeks.
Pain Self-Efficacy Questionnaire (PSEQ)
The PSEQ measures confidence in performing activities despite pain. Scores range from 0 to 60, with higher scores indicating greater self-efficacy.
Time frame: Baseline (postoperative day 0), 6 weeks, and 12 weeks.
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