Effect of Closed Kinetic Chain Exercises Versus Proprioceptive Neuromuscular Facilitation Technique on Pain, Disability and Function of Post Operative Rotator Cuff Injury

Background The shoulder complex demonstrates little to no structural integrity and therefore is prone to multiple injuries, especially in regard to the rotator cuff (RC). RC injury is caused primarily by degenerative changes, micro-trauma secondary to repetitive use, altered mechanics of the scapula, and loss of neuromuscular function. Closed kinetic chain (CKC) exercises and Proprioceptive Neuromuscular Facilitation (PNF) techniques are common interventions in rehabilitation; however, comparative evidence supporting their use following RC repair has been limited. Methods An entire of 120 patients who go through postoperative RC repair were selected and randomly divided into Group A (Closed Kinetic Chain (CKC) exercises) and Group B (PNF techniques) for this randomised controlled trial. Each group contained 60 participants, and the treatment consisted of half hour sessions, 5 days a week, for four weeks. The Shoulder Pain and Disability Indicator (SPADI) and the Western Ontario Rotator Cuff Indicator (WORC) were used to evaluate the results before the start of the study and after completing the four-week training programme. Results There was statistically significant improvement in both SPADI and WORC (p = 0.0001), which indicates a reduction of pain and disability and an increase in functional recovery, after both groups received treatment. The results of the intergroup analysis showed that the mean SPADI scores were not statistically significant (p = 0.87), which suggests that both techniques were equally effectual in terms of pain and disability reduction. On the contrary, the mean WORC scores between both groups were statistically significant (p = 0.0001). Conclusion This study demonstrated that CKC and PNF techniques are equally important in the rehabilitation process of post-operative RCrepair. Although pain and disability outcomes were comparable with each other, the PNF techniques yielded higher functional recovery. The results reinforce the importance of neuro-muscular facilitation and functional integration as a means to improving both post-operative shoulder function and quality of life.