To examine the effect of compensatory strategies training for patients with massive rotator cuff tear (MRCT).

Twenty-four subjects with MRCT were recruited to participate three times shoulder assessments and 12 weeks of intervention. After initial assessment, the subjects were assigned randomly into two groups (CS-TE and TE-CS). CS-TE group was provided compensatory strategies (CS) training followed by 6 weeks of traditional exercise (TE) training. In comparison, TE-CS group took 6 weeks TE training followed by CS. All the participants were arranged to attend the second assessments after completing the first 6 weeks of intervention, and the third assessment at the end of 12 weeks of intervention, including measurements of visual analogue scale (VAS), range of motion (ROM) of shoulder, shoulder pain and disability index (SPADI) questionnaire, shoulder and scapular muscle strength. In addition, scapular kinematics analysis were performed at initial and 2nd assessments.

After the first 6 weeks training, CS-TE group showed significant important in motion pain measurement, SPADI score, AROM and strength of local muscles at 6th week; however, TE-CS group only showed significant improvement in SPADI score and flexion of shoulder. Moreover, after 6 weeks of the CS training, TE-CS group showed significant improvement in VAS and strength of compensatory muscles and scapular muscles. Furthermore, significant improvements in scapular control strategies were only found in CS-TE group after completing 6 weeks of intervention, showing significantly increasing scapular external rotation (ER) and posterior tipping (PT).

Our results have supported that CS training is an effective treatment for establishing the compensatory strategies after MRCT and regaining the shoulder function by strengthening the humeral head depressors and scapular stabilizers.