What should I do if my patient is not compliant with their home exercises?

Encourage them to do their home exercises as instructed, emphasizing the role doing so plays in both the length and success of their recovery, as you would for any patient. However, patient compliance with the home exercise program is distinct from physical therapist compliance with the treatment protocol. When completing the Physical Therapist Report Form(s) [...]

What if a patient I am treating crosses over to the other treatment arm (e.g. operative patient does not have surgery or non-operative patient ends up having surgery)?

You will be referred to the site lead physical therapist for a call to discuss the treatment protocol changes. If needed, you can access the appropriate non-op or post-op PT treatment protocol on the study website: shoulderstudy.org/studies/arc-trial/physical-therapists. After the patient finishes physical therapy, you will receive an additional retrospective PT report form, which you will [...]

What if my post-operative patient has had a surgical procedure other than (or in addition to) a rotator cuff repair? What protocol should I follow?

If a post-operative patient has had alternate or additional surgical procedures, you may modify the treatment protocol as appropriate based on the procedures they received. For example, if an operative patient had a debridement only, you should follow the post-operative treatment protocol but may advance the patient through each phase as tolerated (as opposed to [...]

Do I need to let you know if I substitute different exercises than those in the protocol?

As long as the changes follow the above guidelines, this is not necessary. However, if a particular set of exercises has not been performed at all, this should be reported – along with the reason - in the PT Report Form that will be sent to you to complete. Feel free to contact your site [...]

How much variation from the protocol is acceptable?

As long as the exercises fall into the same category, small changes are acceptable. It is also understood that some patients may not be able to progress as others. This is why the protocols have a function-based progression. Also, if you have an operative patient who had a surgical procedure other than (or in addition [...]

Can I substitute different exercises for those in the protocol? (e.g., Forward Bow instead of Pendulum)

Differences in exercise preference and patients’ needs and understanding are expected. As long as the exercise falls into the same category (i.e., passive range of motion flexion, active-assistive range of motion into external rotation), these substitutions are acceptable.

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