Shoulder activity level is not associated with the severity of symptomatic, atraumatic rotator cuff tears in patients electing nonoperative treatment

Background: Patient activity level may be an important prognostic variable relating to outcomes in patients with shoulder disorders. Little is known about the predictors of activity level in patients with shoulder disorders. Hypothesis: Tear size and patient variables would be predictive of shoulder activity level in a cohort of patients who have selected initial nonoperative treatment for a symptomatic, atraumatic rotator cuff tear on magnetic resonance imaging (MRI). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients with an atraumatic rotator cuff tear on MRI were prospectively enrolled in the Multicenter Orthopaedic Outcomes Network (MOON) shoulder study of nonoperative treatment. As part of routine data collection, these patients were asked to complete a previously validated shoulder activity scale. A regression analysis was performed to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and retraction, and patient factors such as age, sex, smoking, and occupation. Results: A total of 434 patients (220 male, 214 female) with a mean age of 62.7 years (range, 31 -90 years) completed the activity scale. Shoulder activity was not associated with severity of the rotator cuff tear, but it was negatively associated with age (P = .0001) and female sex (P = .001). The only other factor associated with shoulder activity level in this cohort was occupation (P = .0006). Conclusion: Shoulder activity level in patients with an atraumatic rotator cuff tear confirmed on MRI is not associated with severity of the tear but is affected by age, sex, and occupation.