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.
METHODS: 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.
CONCLUSIONS: This consensus provides expert recommendations for the development of rehabilitation guidelines following ASSS. CONTRIBUTION OF THE PAPER.
METHODS: 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.
CONCLUSIONS: This consensus provides expert recommendations for the development of rehabilitation guidelines following ASSS. CONTRIBUTION OF THE PAPER.
摘要：
背景：在英国，关节镜下肩关节稳定手术（ASSS）后没有一致的康复方法。这项研究的目的是同意一套临床实践的术后指南。
方法：专家利益相关者(外科医生，物理治疗师和患者）通过专业网络以及患者参与和参与小组进行识别。进行了三阶段的在线Delphi研究。共识是由OMERACT阈值70％的协议定义的。
结果：11名外科医生，22名物理治疗师和4名患者参加。同意患者应常规固定在吊带中长达3周，但如果有可能，可以更早丢弃。在固定期间，患者只能在一个确定的安全区域内移动。“允许的功能活动包括使用餐具，举起饮料，切片面包,使用厨房用具，擦桌子,轻度除尘，拉起衣服，洗涤/干燥餐具。应避免关闭车门或排水锅。通过范围移动可以在4周后开始，在6周时抵制运动。患者可以根据自己的能力恢复轻度工作，并在12周后恢复体力劳动。当满足返回游戏的功能标记时，返回到非接触式运动。回到接触运动是基于功能和信心后至少12周。确定康复进展时要考虑的其他因素：功能/身体里程碑，患者的信心和运动恐惧症的存在。优选的结果测量是牛津不稳定肩评分。
结论：本共识为制定ASSS后的康复指南提供了专家建议。论文的贡献。
方法：专家利益相关者(外科医生，物理治疗师和患者）通过专业网络以及患者参与和参与小组进行识别。进行了三阶段的在线Delphi研究。共识是由OMERACT阈值70％的协议定义的。
结果：11名外科医生，22名物理治疗师和4名患者参加。同意患者应常规固定在吊带中长达3周，但如果有可能，可以更早丢弃。在固定期间，患者只能在一个确定的安全区域内移动。“允许的功能活动包括使用餐具，举起饮料，切片面包,使用厨房用具，擦桌子,轻度除尘，拉起衣服，洗涤/干燥餐具。应避免关闭车门或排水锅。通过范围移动可以在4周后开始，在6周时抵制运动。患者可以根据自己的能力恢复轻度工作，并在12周后恢复体力劳动。当满足返回游戏的功能标记时，返回到非接触式运动。回到接触运动是基于功能和信心后至少12周。确定康复进展时要考虑的其他因素：功能/身体里程碑，患者的信心和运动恐惧症的存在。优选的结果测量是牛津不稳定肩评分。
结论：本共识为制定ASSS后的康复指南提供了专家建议。论文的贡献。
