Construction Of Rehabilitation Exercise Program After Arthroscopic Rotator Cuff Repair

Objective:①Based on the previous literature review,this study summarized and integrated the best evidence related to the rehabilitation exercise program after arthroscopic rotator cuff repair by systematic evaluation method,and combined with brainstorming method,a Delphi expert inquiry form was preliminarily formed,which can provide a solid theoretical basis for the construction of rehabilitation exercise program after arthroscopic rotator cuff repair;②Through Delphi expert letter consultation,the rehabilitation exercise program after arthroscopic rotator cuff repair is finally formed for clinical reference,and the rehabilitation process can be standardized to provide practical guidance for nursing staff to instruct the shoulder joint function exercise of patients after rotator cuff repair,so as to promote postoperative rehabilitation of patients with rotator cuff injury.Methods:①System evaluation method:Systematically retrieved domestic and foreign guide resources and Chinese and English databases.The search deadline was February 29,2020.By combining free words with mesh words,the literature was retrieved in the resource databases according to the proposed retrieval strategy.Using the 2014 edition of the Australian JBI evidence-based health care center and the JohnHopkins assessment tool to evaluate the evidence grading and quality of the retrieved literature.Meanwhile,key information related to rotator cuff surgery exercise in the literature was extracted,and the rehabilitation exercise program after rotator cuff repair under arthroscopy was summarized.A letter questionnaire was designed for the preliminary plan;②Expert letter consultation method:In the form of a paper or electronic questionnaire,experts in the medical,rehabilitation and nursing-related industries were invited to rate the rationality,importance and operability of the items in the questionnaire and to give specific suggestions for additions,deletions or modifications.With reference to literature review and group discussion,the items with the mean value of rationality,importance and operability<3.5 or coefficient of variation≥0.25 were modified and adjusted.After two rounds of inquiry,the construction of rehabilitation exercise program after arthroscopic rotator cuff repair was completed.Results:①A total of 74 articles were included,and the rehabilitation exercise program after rotator cuff repair under arthroscopy was preliminarily constructed by systematic evaluation method,which was divided into two parts:basic information of the program(5 aspects),specific three-level implementation program(3 first-level items,12 second-level items,37 third-level items);②Through two rounds of Delphi,the rehabilitation program after arthroscopic rotator cuff repair was finally determined after adjusting items.It consists of two parts:the basic information of the program(5 aspects)and the specific three-level implementation program(3 first-level items,12 second-level items,39 third-level items).According to statistics,the effective recovery rate of two rounds was 80%and 85%respectively.The views submission rate was 65%and 29.41%respectively.The expert authority coefficients was 0.8525 and 0.85 respectively.After the second round,the variation coefficient of rationality of basic information of the program was 0.089-0.1414,and the variation coefficient of importance and operability of the three-level items of the program was 0.089-0.1867 and 0.0782-0.202 respectively.The coordination coefficient of the rationality of basic information of the program was 0.303,and the coordination coefficient of the importance and operability of the three-level items of the program was 0.238 and 0.445 respectively.The difference was statistically significant.Conclusion:The rehabilitation program of arthroscopic rotator cuff repair based on systematic evaluation method and Delphi is scientific,reliable and applicable.It provides reference for nursing staff to guide patients after rotator cuff repair,strengthens the rehabilitation management of postoperative patients and promotes the functional recovery of patients.