Latissimus dorsi transfer is an established treatment option with favorable results in massive, irreparable rotator cuff tears, however, it is controversial if earlier motion is detrimental or beneficial to the postoperative goal of reduced pain and improved clinical outcomes. Therefore, the aim of this study is to compare the effects of slow and accelerated rehabilitation protocols after latissimus dorsi transfer in massive, irreparable rotator cuff tears.
Inclusion Criteria: * being in the age range of 18-65 years * being diagnosed with massive, irreparable rotator cuff tears based on magnetic resonance imaging and clinical continuity tests * symptoms are unresponsive to conservative care including steroid injections and physiotherapy for at least 6 months * having a good command of the Turkish language * scoring above 24 in the Mini Mental State Test * ≥80% compliance in completing the post-ARCR Phase 1 trainings * volunteering to participate in the study Exclusion Criteria: * diabetes mellitus * neurological problems * cervical disc herniation * visual, verbal, and/or cognitive defects (aphasia, unilateral neglect, etc.) * systemic inflammatory problems * hypermobility, trauma, and/or inflammation that could be a contraindication for mobilization * former shoulder fractures on the affected side * advanced glenohumeral arthritis (Hamada grade 3), * deltoid muscle dysfunction, * irreparable subscapularis tears, * active infection, * shoulder stiffness, * a history of previous shoulder surgery