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Cochrane Database of Systematic Reviews Protocol - Intervention

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder

This is not the most recent version

Abstract

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

In this review we aim to test the following null hypotheses for patients who have had closed reduction for traumatic anterior dislocation of the shoulder.

(1) No difference exists between outcomes from the different methods (including arm position) and durations (including none or intermittent) of postreduction immobilisation.

(2) No difference exists between outcomes from the provision of rehabilitation intervention (of any kind) versus no intervention.

The rehabilitation intervention can comprise a single modality (e.g. advice for home exercises or hydrotherapy) or be multi‐component. While potentially available to all patients allocated the rehabilitation intervention, its actual application may vary according to the perceived needs of individual patients.

This hypothesis will be tested separately for the provision of any rehabilitation a) during immobilisation, and b) after immobilisation.

(3) No difference exists between outcomes from different types of rehabilitation interventions.

This covers comparisons of different rehabilitation interventions: either different single modalities or different combinations of rehabilitation modalities. However, trials comparing variants of a particular modality will not be considered unless the modality itself has been evaluated.

(4) No difference exists between outcomes from different methods of delivering/providing various rehabilitation interventions.

We plan to test this overall hypothesis separately for different comparisons. These would include supervised therapy versus home exercises, different methods of supervised therapy (e.g. individual versus group instruction), and the frequency and duration of rehabilitation. In the first instance, we do not plan to include comparisons of rehabilitation intervention delivered by individual professionals (e.g. doctors, physiotherapists and occupational therapists) with different levels or backgrounds of expertise or training.

If the data are available, we plan to test the following null hypotheses by patient group:

There are no differences in outcome between patients with first time dislocations, and those with recurrent dislocations.

There are no differences in outcome between physically active young to middle‐aged adults, and those not falling into this category.

There are no differences in outcome between physically active young adults engaged in highly demanding physical activities who have sustained their first traumatic shoulder dislocation, and those not falling into this category.