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Acute rehabilitation following traumatic anterior shoulder dislocation (ARTISAN): pragmatic, multicentre, randomised controlled trial

Objective To assess the effects of an additional programme of physiotherapy in adults with a first-time traumatic shoulder dislocation compared with single session of advice, supporting materials, and option to self-refer to physiotherapy.

Design Pragmatic, multicentre, randomised controlled trial (ARTISAN).

Setting and participants Trauma research teams at 41 UK NHS Trust sites screened adults with a first time traumatic anterior shoulder dislocation confirmed radiologically, being managed non-operatively. People were excluded if they presented with both shoulders dislocated, had a neurovascular complication, or were considered for surgical management.

Interventions One session of advice, supporting materials, and option to self-refer to physiotherapy (n=240) was assessed against the same advice and supporting materials and an additional programme of physiotherapy (n=242). Analyses were on an intention-to-treat basis with secondary per protocol analyses.

Main outcome measures The primary outcome was the Oxford shoulder instability score (a single composite measure of shoulder function), measured six months after treatment allocation. Secondary outcomes included the QuickDASH, EQ-5D-5L, and complications.

Results 482 participants were recruited from 40 sites in the UK. 354 (73%) participants completed the primary outcome score (n=180 allocated to advice only, n=174 allocated to advice and physiotherapy). Participants were mostly male (66%), with a mean age of 45 years. No significant difference was noted between advice compared with advice and a programme of physiotherapy at six months for the primary intention-to-treat adjusted analysis (between group difference favouring physiotherapy 1.5 (95% confidence interval −0.3 to 3.5)) or at earlier three month and six week timepoints. Complication profiles were similar across the two groups (P>0.05).

Conclusions An additional programme of current physiotherapy is not superior to advice, supporting materials, and the option to self-refer to physiotherapy.

Trial registration Current Controlled Trials [ISRCTN63184243.][1]

All data requests should be submitted to WCTUDataAccess@warwick.ac.uk for consideration. Access to anonymised data may be granted following review.

[1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN63184243.

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Key Kiwi F5000 Drivers Have 'Unfinished Business' At Major Category Anniversary Meetings In The USA This Month

Two key members of the four-man SAS Autoparts MSC NZ F5000 Tasman Cup Revival series squad set to travel this month to the USA to join compatriots from there, Australia and the UK in celebrating the 55th anniversary of the stock-block 5-litre V8 wings-and-slicks ...

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Auckland.Scoop » Key Kiwi F5000 Drivers Have 'Unfinished Business' At Major Category Anniversary Meetings In The USA This Month

Scoop Auckland provides news and views from Auckland, New Zealand

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Teenager from Darwen launches streetwear clothing brand

Charlie Talbot has created ‘NO TIES’, which is an independent streetwear brand.

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Pictures from Coronation celebrations in Evesham and Pershore

Pictures from Coronation celebrations in Evesham and Pershore

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