You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
rotator cuff tear is a frequent cause of shoulder pain and can result in weakness , 
 alterations in glenohumeral kinematics , and shoulder instability1 .
arthroscopic surgery is a less - invasive approach to treatment of 
 rotator cuff tears4 .
classical teaching 
 has advocated for passive range of motion exercises in the early postoperative period in an 
 effort to minimize adhesions and stiffness .
mobilization of the joint during the early 
 period of recovery helps to prevent adhesions and reduces the frequency of complications . 

recent retrospective studies have shown that patients who received no formal physical 
 therapy or limited physical therapy regained their range of motion and demonstrated no 
 significant restrictions at 1  year after surgery .
however , no studies have yet evaluated 
 functional outcomes and daily - living activities within the first six months following 
 surgery5,6,7,8,9 .
this study evaluated 
 short - term patient outcomes after arthroscopic rotator cuff repair multiple times at 1 week 
 intervals using a postoperative rehabilitation protocol with early passive motion .
an 82-year - old male fell during a walk , resulting in an inability to raise his right upper 
 limb and pain in his right shoulder .
he was subsequently diagnosed with a supraspinatus tear 
 with fatty infiltration of the muscle belly by magnetic resonance imaging ( fig .
1.magnetic resonance imaging on the left demonstrates the supraspinatus muscle tear 
 where it attaches to the humerus ( white arrow in a)on the right , the same muscle is torn ( white arrow in b ) ) .
the patient had no history of neurological problems , cervical spine disc 
 herniation , or psychological problems and was amenable to therapy .
he was instructed to wear 
 an abduction brace for the first 6 weeks after surgery . from day 1 after surgery , gradually 
 increasing passive range of motion ( rom ) exercises including forward flexion and internal 
 and external rotation were performed twice a day with the support of a therapist ( fig . 2fig .
finally at 
 12 weeks after surgery , gradually increasing muscle strengthening exercises were introduced . 

after discharge , the patient continued 
 this rehabilitation program 23 times per week until 20 weeks after surgery .
the patient was 
 examined using several standardized rom assessments such as forward flexion and abduction 
 every week until 20 weeks after surgery , and the results were recorded .
magnetic resonance imaging on the left demonstrates the supraspinatus muscle tear 
 where it attaches to the humerus ( white arrow in a ) on the right , the same muscle is torn ( white arrow in b ) early rehabilitation protocol following arthroscopic rotator cuff repair active rom ( forward flexion , extension , internal and external rotation and abduction ) , the 
 ucla shoulder rating scale ( ucla scale ) , and the quick disabilities of the arm , shoulder , 
 and hand ( quickdash ) questionnaire assessments were performed and recorded every week after 
 surgery except for weeks 13 , 15 , and 16 , due to patient scheduling variables . the ucla scale 
 has been used to describe the outcome of interventions for many shoulder conditions , 
 including rotator cuff tears .
activities of daily living ( adl ) were assessed with the 
 quickdash10 , 11 .
the quickdash questionnaire is a self - reported questionnaire that 
 reflects the functional state and symptoms from the patient s perspective .
furthermore , the 
 quickdash evaluates disability due to upper extremity injury ( quickdash disability / symptom ) 
 as well as the limitations of work - related activities ( quickdash work ) and leisure 
 ( quickdash sports / music ) .
the subject provided written informed consent to take part in the 
 study prior to its commencement , and the study conformed to the principles of the 
 declaration of helsinki .
this study was conducted with the approval of the research ethics 
 committee of health science university ( approval number : 30 ) .
until 6 weeks after surgery , the primary goals were to decrease pain , improve healing , and 
 restore normal joint motion ( fig .
, the rehabilitation goals included weaning off the abduction 
 brace and increasing active rom .
rehabilitation criteria included adequate passive rom for 
 advancement , minimal substitution patterns with passive rom exercises , and minimal pain with 
 passive rom ( fig .
2 , phase ii ) . at 6 weeks after 
 surgery , pain had nearly disappeared .
active forward flexion , internal rotation , and 
 external rotation were 150 , 70 , and 60 , respectively ( fig 3fig .
3.range of motion during the early rehabilitation protocol after arthroscopic rotator 
 cuff repair ) .
the ucla scale score and quickdash disability / symptom score were 34 and 36 points , 
 respectively ( fig 4fig .
4.ucla scale and quickdash questionnaire scores during the early rehabilitation 
 protocol after arthroscopic rotator cuff repairucla scale : ucla shoulder scoring scale ; dash - d : quickdash disability / symptom module ; 
 dash - w : quickdash work module ; dash - s / m : quickdash sports / music module ) . at 10 weeks after surgery , the patient was discharged and able to resume work and 
 sports ( quickdash work and sports / music scores of 44 and 31 points , respectively ) . 

subsequently , rom and quickdash scores regressed ( active forward flexion , 120 ; quickdash 
 disability / symptom score , 25 points ) compared with at 710 weeks after surgery ( fig 3 and 4 ) . from 20 weeks after surgery , the 
 advanced strengthening phase can typically be initiated ( fig .
active rom values were higher 
 compared with at 10 weeks after surgery , and active internal rotation , external rotation , 
 and abduction were 80 , 80 , and 160 , respectively ( fig . 
 3 ) .
the quickdash disability / symptom and 
 sport / music scores were both 0 points .
furthermore , his disability related to  difficult 
 housework  improved , so all disability parts of the quickdash became 0 points ( fig .
range of motion during the early rehabilitation protocol after arthroscopic rotator 
 cuff repair ucla scale and quickdash questionnaire scores during the early rehabilitation 
 protocol after arthroscopic rotator cuff repair ucla scale : ucla shoulder scoring scale ; dash - d : quickdash disability / symptom module ; 
 dash - w : quickdash work module ; dash - s / m : quickdash sports / music module
rehabilitation is an important component in the postoperative recovery of patients after 
 rotator cuff repair .
although patient age , activity level , and tear size influence surgical 
 decision - making , nonsurgical management is frequently the preferred method of initial 
 treatment after a rotator cuff tear12 . 

recently , rehabilitation protocols have varied considerably among providers with respect to 
 both timing of progression and application of therapeutic exercise13 .
conducted a retrospective review of 43 
 patients in which no formal physical therapy was started until 6 weeks after surgery . in an 
 examination at 6 weeks after surgery , they noted that 23% of their patients had residual 
 stiffness ; however , at 1  year after surgery , the patients had regained their range of 
 motion , with no significant restrictions at the final follow - up assessment14 . in a prospective randomized study , cuff 
 et al . determined that both early and delayed range of motion groups had similar clinical 
 outcomes at 1  year after arthroscopic repair of a full - thickness supraspinatus tear
the 
 early range of motion group regained a greater average forward elevation ( 172 ) compared 
 with the delayed group ( 165 ; p<0.0001 ) at 6 months .
however , their values had equalized 
 by 1  year , and rom tests revealed similarly improved results in both groups .
forward 
 elevation was 174 in the early group and 173 in the delayed group .
external rotation was 
 46 in the early group and 45 in the delayed group , with no statistical differences between 
 the two groups15 .
this study evaluated short - term patient outcomes after arthroscopic rotator cuff repair 
 using a postoperative rehabilitation protocol with early passive rom exercises . at 6 weeks 
 after surgery , pain almost disappeared and rom was high .
active forward flexion , internal 
 rotation , and external rotation were 150 , 70 , and 60 , respectively . particularly after 
 arthroscopic rotator cuff repair , an early rehabilitation protocol must be carefully 
 administered until 6 weeks after surgery because the first 6 weeks after surgery represent 
 an important period for ingrowth of the tendon to the bone surface16 .
this phase typically lasts for 48 weeks after surgery , 
 but may be delayed , depending on the age of the patient and quality and size of the repair . 

cellular proliferation and matrix deposition during this phase are thought to be regulated 
 by several growth factors and initially yield primarily type iii collagen17 .
the patient was discharged at 10 weeks after surgery , and his rom and quickdash scores 
 regressed ( active forward flexion , 120 ; quickdash disability / symptom score , 25 points ) 
 compared with at 710 weeks after surgery ( figs . 2 
 and 3 ) . at discharge
, the adl of this patient 
 greatly changed , as he resumed work and leisure18 .
it is imperative that the therapist watch for increases in adls 
 and modify the home exercise program at the time of discharge to account for increases in 
 stress on the shoulder .
return to work should occur only after the patient has been cleared 
 by the therapist , has achieved symmetric motion and strength and a normalized scapulohumeral 
 rhythm , and has no complaints of pain at rest or during activities19 .
this study demonstrates that there may be advantages to prescribing formal physical therapy 
 that includes early passive range of motion exercise for patients undergoing arthroscopic 
 repair for a full - thickness supraspinatus tear .
early rehabilitation protocols are 
 recommended to physical therapists during rehabilitation for arthroscopic rotator cuff 
 repair to support rapid reintegration into daily - living activities .
early rehabilitation 
 after rotator cuff repair resulted in greater recovery in a shorter time span , which in turn 
 is related to adl and convenience for the patient .
this study was only one case , and comparisons with gentle 
 rehabilitation have not been done . in the future , further studies are needed that compare 
 the effectiveness of early rehabilitation compared with conventional rehabilitation for 
 short - term outcomes after arthroscopic rotator cuff repair .
[ purpose ] the effect of early rehabilitation protocols after arthroscopic rotator cuff 
 repair is currently unknown . we examined short - term effects of early rehabilitation on 
 functional outcomes and activities of daily living after arthroscopic rotator cuff repair . 
 [ subject and methods ] an 82-year - old male fell during a walk , resulting in a supraspinatus 
 tear . 
 arthroscopic rotator cuff repair was performed using a single - row technique . 
 he wore 
 an abduction brace for 6 weeks after surgery . 
 [ results ] from day 1 after surgery , passive 
 range of motion exercises , including forward flexion and internal and external rotation 
 were performed twice per day . 
 starting at 6 weeks after surgery , active range of motion 
 exercises and muscle strengthening exercises were introduced gradually . at 6 weeks after 
 surgery , his active forward flexion was 150 , ucla shoulder rating scale score was 34 
 points , and quick disabilities of the arm , shoulder , and hand questionnaire 
 disability / symptom score was 36 points . at 20 weeks after surgery , 
 his active forward 
 flexion was 120 , ucla shoulder rating scale score was 34 points , and quick disabilities 
 of the arm , shoulder , and hand questionnaire disability / symptom score was 0 points 
 . 
 [ conclusion ] these protocols are recommended to physical therapists during rehabilitation 
 for arthroscopic rotator cuff repair to support rapid reintegration into activities of 
 daily living .