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Pedley C1,2
1Keele University, School of Health and Rehabilitation, Keele, United Kingdom, 2Sheffield Hallam University, Physiotherapy, Sheffield, United Kingdom
Background: Paediatric Shoulder instability is the leading pathology seen by the shoulder service at the Royal Manchester Children's Hospital. The management of paediatric shoulder conditions is therefore of paramount importance in reducing financial costs to the NHS. However, children are having to wait for long periods to be reviewed within this service. This is neither ideal nor acceptable.
Purpose: To evaluate the shoulder service assessment tool which is a data capturing method for subjective and objective shoulder examination at the Royal Manchester Children's Hospital and identify whether waiting times can be cut by improving initial assessment and pathway based care.
Methods: One hundred paediatric patients aged between 0-18 with a history of a shoulder complaint were recruited and their assessments retrospectively evaluated. Demographic data was analysed using gender, age and laterality of injury. Cluster analysis was completed to allow for the formation of clusters statistically.
Results: Significant differences were found showing that females were more predisposed to birthing trauma secondary to the hormone relaxin, whereas males were more predisposed to traumatic injury secondary to poor decision making. The average age for presentation with a shoulder injury was 10.9 years of age with most shoulder complaints occurring after 11 years of age. The ideal number of clusters was four clusters, demonstrated by three separate types of cluster analysis, statistical significance was demonstrated in the formation of four clusters.
Conclusion(s): The Stanmore Triangle of shoulder instability fails to capture all the data effectively for the paediatric population, a diamond format is more appropriate to provide a visual representation. Physiotherapy led triaging service for the shoulder service at RMCH would reduce waiting times, improve cost effectiveness, improve patient experience and continue to promote the need for specialist Physiotherapists within the NHS.
Implications: Physiotherapists should be the front line triage in dealing with paediatric shoulder complaints.
A new system of classification of shoulder instability paves the way for evidence based treatment protocols and effective management
Keywords: Paediatrics, Shoulder Instability, Physiotherapy
Funding acknowledgements: Self funded
Purpose: To evaluate the shoulder service assessment tool which is a data capturing method for subjective and objective shoulder examination at the Royal Manchester Children's Hospital and identify whether waiting times can be cut by improving initial assessment and pathway based care.
Methods: One hundred paediatric patients aged between 0-18 with a history of a shoulder complaint were recruited and their assessments retrospectively evaluated. Demographic data was analysed using gender, age and laterality of injury. Cluster analysis was completed to allow for the formation of clusters statistically.
Results: Significant differences were found showing that females were more predisposed to birthing trauma secondary to the hormone relaxin, whereas males were more predisposed to traumatic injury secondary to poor decision making. The average age for presentation with a shoulder injury was 10.9 years of age with most shoulder complaints occurring after 11 years of age. The ideal number of clusters was four clusters, demonstrated by three separate types of cluster analysis, statistical significance was demonstrated in the formation of four clusters.
Conclusion(s): The Stanmore Triangle of shoulder instability fails to capture all the data effectively for the paediatric population, a diamond format is more appropriate to provide a visual representation. Physiotherapy led triaging service for the shoulder service at RMCH would reduce waiting times, improve cost effectiveness, improve patient experience and continue to promote the need for specialist Physiotherapists within the NHS.
Implications: Physiotherapists should be the front line triage in dealing with paediatric shoulder complaints.
A new system of classification of shoulder instability paves the way for evidence based treatment protocols and effective management
Keywords: Paediatrics, Shoulder Instability, Physiotherapy
Funding acknowledgements: Self funded
Topic: Paediatrics; Musculoskeletal: upper limb
Ethics approval required: Yes
Institution: Manchester Foundation Trust
Ethics committee: CMFT Ethics GAFREC
Ethics number: R04307
All authors, affiliations and abstracts have been published as submitted.
