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Publication Rehabilitation guidelines following arthroscopic shoulder stabilisation surgery for traumatic instability - a Delphi consensus(Elsevier, 2024-05-16) Willmore, Elaine; Bateman, Marcus; Maher, Natasha; Chester, Rachel; O'Sullivan, Joel; Horsley, Ian; Blacknall, James; Gibson, Jo; Jaggi, Anju; Willmore, Elaine; Allied Health ProfessionalBackground: 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.Publication Rehabilitation following shoulder arthroscopic stabilisation surgery: A survey of UK practice(SAGE Publications, 2023-02-10) Maher, Natasha; Willmore, Elaine; Bateman, Marcus; Blacknall, James; Chester, Rachel; Horsley, Ian; Gibson, Jo; O' Sullivan, Joel; Jaggi, Anju; Willmore, Elaine; Allied Health ProfessionalBackground: Optimal rehabilitation following arthroscopic shoulder stabilisation for traumatic anterior instability is unknown. The purpose of this study was to establish current UK practice for this patient group. Methods: A self-administered online questionnaire was developed and distributed to UK surgeons and physiotherapists. Results: 138 responses were received. Routine immobilisation was reported in 79.7% of responses with a cross-body sling being the preferred position (63.4%). Duration of immobilisation and timescales to initiate movement were highly variable. Return to light work was advised when patients felt able (25.4%) or after 6 weeks (26.1%). 58.7% recommended waiting for 12 weeks to return to manual work. 56% recommended non-contact sport could be resumed after 12 weeks. For contact sport, recommendations varied from 6 weeks (3.8%) to 6 months (5.8%). Psychological readiness was the most frequently cited criteria for return to play (58.6%). Factors such as hyperlaxity (40.6%), age (32.6%) and kinesiophobia (28.3%) were not considered as relevant as reported quality of surgical fixation (50%). Conclusion: There is no clear consensus regarding optimal post-operative rehabilitation following arthroscopic shoulder stabilisation. Further work is required to establish high value, personalised pathways for this patient group.Publication CSP2023: 390 - “My Life” Group Evaluation: How a Co-produced Lifestyle Programme can support Individuals with Severe Mental Illness to live well(Elsevier, 2024-06-18) Dowdeswell, Nicola; Walker, Mark; Willmore, Elaine; Vidal, S; Bayliss, Nigel; MacFarland, Simon; Chidgey, Helen; Vincze, Andrea; Dowdeswell, Nicola; Walker, Mark; Willmore, Elaine; Vidal, S; Bayliss, N; MacFarland, S; Chidgey, Helen; Vincze, Andrea; Allied Health Professional; Admin and Clerical; OtherNo abstract available