Abstract

Objectives: This study examined whether gait and trunk acceleration changes around brace removal were associated with falls within 30 days after discharge after arthroscopic rotator cuff repair (ARCR).

Patients and methods: This single-center exploratory observational study included 49 patients who underwent ARCR with a 30-day follow-up between May 2025 and April 2026. Gait was assessed immediately before brace removal (T3) and immediately after brace removal on the day of discharge (T4) using a triaxial accelerometer at the third lumbar vertebra. Gait speed, step length, and trunk acceleration root-mean-square (RMS) were analyzed. Falls within 30 days after discharge were recorded during outpatient rehabilitation visits. Between-group comparisons used the Mann-Whitney U test, Fisher’s exact test, and Cohen’s d.

Results: Forty-nine participants were divided into two groups based on their fall status: non-fallers (21 males, 15 females; mean age: 70.7 ± 7.9 years; range, 48 to 84 years) and fallers (5 males, 8 females; mean age: 74.8 ± 6.0 years; range, 65 to 86 years; 13/49, 26.5%). Median time from the post-brace removal assessment to first fall was two days (interquartile range 1-6), and 11 of 13 fallers (84.6%) fell within seven days. Before brace removal, no group differences were observed. After brace removal, fallers showed lower gait speed, shorter step length, and higher RMS total. Changes across brace removal showed the largest between-group differences in all primary gait parameters (all p ≤ 0.010; Cohen’s d = 0.82-1.44).

Conclusion: Early falls after ARCR were associated with gait and trunk-control changes across brace removal rather than with pre-removal gait performance itself. Clinicians should consider reassessing gait and providing targeted fall-prevention education at the time of brace removal.

Citation: Kamimura A, Takayama K. Brace-removal transition, gait changes, and early falls after arthroscopic rotator cuff repair. Arch ISPRM 2026;1(2):171-179. https://doi.org/10.5606/ archisprm.2026.70.

A.K.: Conceived and designed the study, collected the data, performed the statistical analyses, and drafted the manuscript; K.T.: Supervised the surgical and clinical aspects of the study and critically revised the manuscript for important intellectual content. Both authors approved the final version of the manuscript and accept accountability for all aspects of the work.

The authors declare that there are no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

This research received no specific grant from any funding agency in the public, commercial, or not‑for‑profit sectors.

AI Disclosure
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

The authors thank the rehabilitation and orthopaedic staff of Mabi Memorial Hospital for their assistance with data collection, and the participants for their cooperation.