Rehabilitation guidelines following arthroscopic shoulder stabilisation surgery for traumatic instability – a Delphi consensus

Willmore, Elaine, Bateman, Marcus, Maher, Natasha, Chester, Rachel ORCID: https://orcid.org/0000-0003-1979-0682, O’Sullivan, Joel, Horsley, Ian, Blacknall, James, Gibson, Jo and Jaggi, Anju (2024) Rehabilitation guidelines following arthroscopic shoulder stabilisation surgery for traumatic instability – a Delphi consensus. Physiotherapy, 124. pp. 154-163. ISSN 0031-9406

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Abstract

Background: There is no consistent approach to rehabilitation following arthroscopic shoulder stabilisation surgery (ASSS) in the UK. The aim of this study was to agree a set of post-operative guidelines for clinical practice.   Method: Expert stakeholders (surgeons, physiotherapists and patients) were identified via professional networks and patient involvement and engagements groups. A three-stage online Delphi study was undertaken. Consensus was defined by the OMERACT threshold of 70% agreement.   Results: 11 surgeons, 22 physiotherapists and 4 patients participated. It was agreed patients should be routinely immobilised in a sling for up to 3 weeks but can discard earlier if able. During the immobilisation period, patients should move only within a defined “safe zone.” Permitted functional activities include using cutlery, lifting a drink, slicing bread, using kitchen utensils, wiping a table, light dusting, pulling up clothing, washing/drying dishes. Closing car doors or draining saucepans should be avoided. Through range movements can commence after 4 weeks, resisted movements at 6 weeks. Patients can resume light work as they feel able and return to manual work after 12 weeks.   Return to non-contact sports when functional markers for return to play are met was agreed. Return to contact sport is based on function & confidence after a minimum of 12 weeks. Additional factors to consider when determining rehabilitation progression: functional/physical milestones, patient’s confidence and presence of kinesiophobia. The preferred outcome measure is the Oxford Instability Shoulder Score.   Conclusion: This consensus provides expert recommendations for the development of rehabilitation guidelines following ASSS.

Item Type:	Article
Uncontrolled Keywords:	instability,post-operative rehabilitation,rehabilitation,shoulder,shoulder stabilisation surgery,physical therapy, sports therapy and rehabilitation ,/dk/atira/pure/subjectarea/asjc/3600/3612
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	21 May 2024 09:30
Last Modified:	30 Sep 2024 13:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/95250
DOI:	10.1016/j.physio.2024.05.001

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