الفهرس 
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Abstract
Rotator cuff tear is an injury or inflammation of one or more of the tendons or muscles of the rotator cuff of the shoulder, it may be full or partial thickness tears. A full thickness rotator cuff tear occurs when the entire tendon tears off the bone, while partial thickness rotator cuff tear occurs when only part of the tendon separates from the bone, and it also, may be acute or chronic. In Egypt, the most frequent type of shoulder pathologies is impingement syndrome and represented 38.6% followed by rotator cuff tear and represented 17.8%. Annual incidence of shoulder pain is 2.4% at rate 17 per 1000 person per year for middle aged adults in 2022 (Mohamed, Elkady, Usama, Abdelmonem, Doaa, 2022).
Rotator cuff strains or tears are caused by overuse or acute injury. The rotator cuff can also strain or tear after a fall, a car accident, or another sudden injury. Treatment may be conservative or surgical. For surgical treatment of rotator cuff tear is used to repair a torn rotator cuff most often involves re attaching the tendon to the head of humerus.
Exercises are an integral and very important part of the intervention after rotator cuff surgery. It is useful in improving range of motion and functional abilities, and helping to enhance muscle control and strength in the involved upper extremity, and maximize patients’ mobility with a goal of functional independence. So, rehabilitation program about exercises should be started early in postoperative phase after rotator cuff surgery.
The aim of this study was:
To evaluate the effect of a nursing rehabilitation program on shoulder joint range of motion and functional abilities for patients post rotator cuff surgery.
Research Design:
A quasi experimental research design was utilized.
Setting:
The study was carried out at the inpatient units G and outpatient clinic of Hadara Orthopedic and Traumatology University Hospital, Alexandria.
Subjects:
A convenience sample of sixty adult patients (40-60 years) were scheduled for rotator cuff surgery, and assigned randomly and alternatively into two equal groups (control & study groups),which included 30 patients in each group.
The control group (I): was exposed to the routine hospital care (Passive range of motion exercises).
The study group (II): followed the rehabilitation program, which was carried out by the researcher for the patients.
Tools of the study: Five tools were used for data collection in this study: Tool I: Rotator cuff surgery patient’s assessment: structured interview schedule.
Tool II: Modified visual analog scale.
Tool III: Range of motion of the affected shoulder.
Tool IV: Muscle strength scale of the affected shoulder.
Tool V: Functional abilities of the upper limb.
Data collection:
The data collection was started, and continued from April 2020 to September 2020.
The data was collected from the control group patients first, then the study group patients to prevent data contamination.
The study was carried out on four phases:
1. Assessment phase:
Initial assessment was carried out for both groups (control & study) on the second day post rotator cuff surgery at the inpatient units of Hadara Orthopedic and Traumatology University Hospital, Alexandria.
2. Planning phase:
Based on the data obtained from the initial assessment phase and review of the related literature (Craven & Hirnle, 2009), the planning of rehabilitation program was developed for patients by the researcher. Demonstration and re demonstration were formulated for the patients of the study group (II).
3. Implementation phase:
A nursing rehabilitation program was implemented individually for patients in the study group in two sessions. The two sessions were done the second week post rotator cuff surgery in the outpatient clinic of Hadara Orthopedic and Traumatology University Hospital, Alexandria and each session took 30-60 minutes. A colored booklet was distributed to patients of the study group II. Demonstration, and re demonstration were used for practical session.
4. Evaluation phase:
All patients in both groups were evaluated three times, the second day post surgery, the second week and two months post rehabilitation program implementation in the inpatient unit and outpatient clinic using tools I, II, III, IV and V.
The main results of the study:
The results showed that, more than three quarters 76.7% of patients of the control group and more than two thirds 66.7% of patients of the study group were in the age group 40 to less than 50 years old, while for gender, it was found that, more than two thirds 66.7% of patients of the control group and 73.3% of patients of the study group were females. Concerning occupation, it can be noticed that more than two thirds 66.7% of patients of the control group and half 50% of patients of the study group were housewives.
The results revealed that, the control group had unsatisfactory knowledge the second day post surgery, the second week & two months post rehabilitation program (96.7%,96.7%,90% respectively) compared to (90%, 63.3%, 40% respectively) of patients of the study group, with statistically significant difference among them (p0=0.000*). In addition, there was statistical significance difference between patients of both studied groups regarding range of motion, muscle strength, and overall functional abilities of the affected shoulder two months post rehabilitation program.
Conclusion:
The nursing rehabilitation program has been proven to give a positive result in relation to patients’ shoulder joint range of motion and functional abilities post rotator cuff surgery.
There has been an improvement in pain score, range of motion, muscle strength of the affected shoulder, the functional abilities and self care activities two months post rehabilitation program in the study group patients.
The main recommendations are:
1. Replication of the study on large probability sampling.