# Predicting the Outcome of Exercise Therapy for Treatment of Rotator Cuff Tears

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $650,779

## Abstract

Project Summary
Rotator cuff tears are a significant clinical problem, resulting in 30% of all visits to orthopaedic surgeons and over
150,000 surgical procedures per year. Rotator cuff tears occur frequently in the middle-to-late aged population
and can cause severe pain, disability and activity limitations. Exercise therapy is typically prescribed for initial
treatment of rotator cuff tears and is often effective at relieving symptoms. However, exercise therapy fails to
relieve symptoms in 25-50% of cases, requiring surgical intervention. Thus, we conducted a prospective
observational cohort study of 109 individuals with a symptomatic isolated supraspinatus tendon tear who
underwent a personalized exercise therapy program (POETT Cohort). In addition to a much lower incidence of
surgery (6.4%) at 2-year follow-up, our exercise therapy program led to significant improvements in passive
glenohumeral range of motion, isometric muscle strength, patient-reported outcomes, and in-vivo
arthrokinematics without increases in rotator cuff tear size. Initial computational modeling efforts using subject-
specific inputs demonstrate that individuals who underwent surgery have less stable glenohumeral joints after
exercise therapy. Due to the lower incidence of surgery in the POETT Cohort and the aforementioned findings,
we seek to determine the mechanistic and clinical factors that could be associated with the improved outcomes.
Therefore, the overall objective of our project is to determine the long-term viability of exercise therapy
for treatment of individuals with rotator cuff tears using our unique POETT Cohort by assessing
important biomechanical and clinical parameters. The project will address three specific aims: Aim 1)
Determine durability of an exercise therapy program to provide clinicians with information related to factors
associated with the success or failure of exercise therapy. Changes in PROs at 3-, 4-, and 5-years; rotator cuff
tear size at 5-years; in-vivo glenohumeral kinematics at 5-years and subsequent surgery following exercise
therapy will be collected; Aim 2) Assess the relative magnitude of improvements in arthrokinematics over 5-
years for the POETT Cohort with respect to healthy control subjects; Aim 3) Assess restoration and maintenance
of glenohumeral joint stability in subjects with a rotator cuff tear that undergo exercise therapy. Changes in the
magnitude and direction of the glenohumeral joint reaction force will be determined for those that were
successfully treated with exercise therapy compared to those that underwent subsequent surgery and control
subjects utilizing musculoskeletal models. We hypothesize that exercise therapy maintains the health of the
rotator cuff over a period of 5-years and joint function will be similar to age-, sex- and hand dominance frequency
matched individuals. These analyses will allow for continued development of individualized treatment protocols
through determination of the durability of ...

## Key facts

- **NIH application ID:** 10923937
- **Project number:** 5R01AR069503-07
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Richard E Debski
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $650,779
- **Award type:** 5
- **Project period:** 2016-09-07 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10923937

## Citation

> US National Institutes of Health, RePORTER application 10923937, Predicting the Outcome of Exercise Therapy for Treatment of Rotator Cuff Tears (5R01AR069503-07). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10923937. Licensed CC0.

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