Publications by authors named "David Ellard"

Background: Acute Rehabilitation following Traumatic anterior shoulder dISlocAtioN (ARTISAN) was a large trial comparing the clinical and cost-effectiveness of two rehabilitation interventions in adults with a first-time traumatic shoulder dislocation. Participants were allocated to receive either a single session of advice (ARTISAN) or a single session of advice and a programme of physiotherapy (ARTISAN plus). Trial results illustrated that additional physiotherapy after an initial session was not superior in improving functional outcomes for participants.

View Article and Find Full Text PDF
Article Synopsis
  • * The REPPORT trial is a multicenter study comparing personalized rehabilitation to surgery for managing this condition, targeting 276 participants across the UK and using random assignment to treatment groups.
  • * The trial will evaluate effectiveness based on participant-reported outcomes over 18 months and gather additional data on health impacts and resource use, with results set to be shared in peer-reviewed publications.
View Article and Find Full Text PDF
Article Synopsis
  • The Chronic Headache Education and Self-management Study (CHESS) aimed to develop supportive strategies for individuals suffering from chronic headaches, revealing a lack of qualitative research on their lived experiences.
  • Researchers conducted semi-structured interviews with participants from the CHESS study, analyzing the results through thematic analysis to understand the complexities of living with chronic headaches.
  • The study identified six major themes related to the emotional impact and nature of headaches, alongside four overlapping categories of headache impact, highlighting the varying degrees to which headaches affect participants' lives over time.
View Article and Find Full Text PDF
Article Synopsis
  • The KARDS trial studied if knee joint distraction (KJD) is as good as knee replacement surgery (KR) for treating knee problems.
  • Researchers talked to 11 staff members and 11 patients to understand their experiences and feelings during the trial.
  • Key findings showed that giving clear information about treatments and recovery is super important, and they learned that having a good rehab plan after KJD is necessary for helping patients recover smoothly.
View Article and Find Full Text PDF

Introduction: Pain and disability after meniscectomy can be a substantial lifelong problem. There are few treatment options, especially for young people. Non-surgical management (rehabilitation) is an option but increasingly surgeons are performing meniscal allograft transplants (MATs) for these individuals.

View Article and Find Full Text PDF

Background: Free tissue transfer (FTT) for reconstruction of diabetic foot disease (DFD) is an emerging field to preserve the lower limb within this patient group. The design of future quantitative research and clinical services in this area must consider the needs, expectations and concerns of patients. This qualitative study explores patient experiences of FTT for reconstruction of DFD.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to understand individuals' perspectives on recovery after total knee replacement (TKR) and identify key recovery areas they deemed important.
  • Semi-structured interviews were conducted with 12 participants at various stages of their TKR journey, using thematic analysis to uncover common themes including pain, function, and fears related to surgery.
  • Findings emphasized the significance of pain management and mobility as central concerns for TKR patients, suggesting that these aspects should be considered in both clinical practice and future research designs.
View Article and Find Full Text PDF

Background: The extra benefit of a programme of physiotherapy in addition to advice alone, following first-time traumatic shoulder dislocation, is uncertain. We compared the clinical and cost-effectiveness of a single session of advice with a single session of advice and a programme of physiotherapy.

Objective: The primary objective was to quantify and draw inferences about observed differences in the Oxford Shoulder Instability Score between the trial treatment groups 6 months post randomisation, in adults with a first-time traumatic shoulder dislocation.

View Article and Find Full Text PDF

Aim: To review qualitative studies on the experience of sudden cardiac arrest survival from the perspective of both survivors and their key supporters, including family/close friends.

Methods: A seven-step meta-ethnography and synthesis of qualitative evidence was undertaken, informed by the Meta-Ethnography Reporting Guidelines (eMERGe). Four major databases were searched (Medline, EMBASE, CINAHL, PsycINFO; January 1995-January 2022, updated July 2023) for qualitative studies exploring survivors' and/or key supporters' experiences of cardiac arrest survival.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how the COVID-19 pandemic has intensified existing ethnic inequalities in mental healthcare, focusing on the perspectives of patients, carers, and mental health professionals in England.* -
  • Key findings indicate that pre-pandemic barriers such as mistrust and a monocultural service model were worsened by the pandemic, through factors like remote service delivery and community organization closures, leading to greater alienation and communication issues.* -
  • Despite some patients experiencing positive changes, such as increased empowerment, the overall decline in group-specific services requires urgent attention to improve engagement and support for minority ethnic groups in mental healthcare.*
View Article and Find Full Text PDF

Background: The haphazard adoption of new surgical technologies into practice has the potential to cause patient harm and there are many misconceptions in the decision-making behind the adoption of new innovations. The aim of this study was to synthesize factors affecting a surgeon's decision to adopt a novel surgical innovation into clinical practice.

Methods: A systematic literature search was performed to obtain all studies where surgeon views on the adoption of a novel surgical innovation into clinical practice have been collected.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • The text discusses the growing use of robotic-assisted hip replacement surgeries, aimed at enhancing surgical precision and potentially improving patient outcomes despite higher costs compared to traditional methods.
  • A randomized controlled trial (RACER-Hip) will be conducted across multiple UK sites, involving 378 participants to compare outcomes between robotic-assisted and conventional total hip replacement surgeries.
  • The study aims to evaluate various factors, including pain, joint awareness, and overall satisfaction, with a thorough ethical review process already in place for participant consent.
View Article and Find Full Text PDF

Background: Long-standing ethnic inequalities in access and mental healthcare were worsened by the COVID-19 pandemic.

Objectives: Stakeholders coproduced local and national implementation plans to improve mental healthcare for people from minority ethnic groups.

Methods: Experience-based codesign conducted in four areas covered by National Health Service (NHS) mental health trusts: Coventry and Warwickshire, Greater Manchester, East London and Sheffield.

View Article and Find Full Text PDF

Introduction: Robotic-assisted knee replacement systems have been introduced to healthcare services worldwide in an effort to improve clinical outcomes for people, although high-quality evidence that they are clinically, or cost-effective remains sparse. Robotic-arm systems may improve surgical accuracy and could contribute to reduced pain, improved function and lower overall cost of total knee replacement (TKR) surgery. However, TKR with conventional instruments may be just as effective and may be quicker and cheaper.

View Article and Find Full Text PDF

Background: The Chronic Headache Education and Self-Management Study (CHESS) multicentre randomised trial evaluated the impact a group education and self-management support intervention with a best usual care plus relaxation control for people living with chronic headache disorders (tension type headaches or chronic migraine, with or without medication overuse headache). Here we report the process evaluation exploring potential explanations for the lack of positive effects from the CHESS intervention.

Methods: The CHESS trial included 736 (380 intervention: 356 control) people across the Midlands and London UK.

View Article and Find Full Text PDF

Background And Objectives: Chronic headache disorders are a major cause of pain and disability. Education and supportive self-management approaches could reduce the burden of headache disability. We tested the effectiveness of a group educational and supportive self-management program for people living with chronic headaches.

View Article and Find Full Text PDF

Background: Current measures of health-related quality of life are neither sufficiently sensitive or specific to capture the complex and heterogenous nature of the recovery and survivorship associated with cardiac arrest. To address this critical practice gap, we plan a mixed-methods study to co-produce and evaluate a new cardiac arrest-specific patient/survivor-reported outcome measure (PROM).

Methods: International guidelines have informed a two-stage, iterative, and interactive process.

View Article and Find Full Text PDF

Background: Low back pain (LBP) is a common condition with substantial associated disability and costs, best understood using a biopsychosocial approach. Research demonstrates that beliefs about LBP are important, with biomedical beliefs influencing practitioner's management and patient recovery. Beliefs about LBP can be inconsistent amongst healthcare and medical students.

View Article and Find Full Text PDF

Introduction: Knee replacement (KR) is a clinically proven procedure typically offered to patients with severe knee osteoarthritis (OA) to relieve pain and improve quality of life. However, artificial joints fail over time, requiring revision associated with higher mortality and inferior outcomes. With more young people presenting with knee OA and increasing life expectancy, there is an unmet need to postpone time to first KR.

View Article and Find Full Text PDF
Article Synopsis
  • Suprascapular nerve block (SSNB) injections are becoming popular for treating chronic shoulder pain, but the best way to do them and take care afterward isn't clear yet.
  • This review included 53 studies and found eight different methods for giving these injections, with indirect surface landmark methods being the most common.
  • There was also a lot of differences in the types of medicines used, with local anesthetics being the main ingredient, and experts say we need to agree on a standard way to perform these injections for better future care.
View Article and Find Full Text PDF

Background: Patient and public involvement (PPI) plays a crucial role in ensuring research is carried out in conjunction with the people that it will impact upon. In this article, we present our experiences and reflections from working collaboratively with patients and public through the lifetime of an National Institute for Health Research (NIHR) programme grant; the Chronic Headache Education and Self-management Study (CHESS) which took place between 2015 and 2020.

Ppi Over The Course Of Chess: We worked closely with three leading UK migraine charities and a lay advisory group throughout the programme.

View Article and Find Full Text PDF

Objective: Optimum physiotherapy management for people with a conservatively managed primary traumatic anterior shoulder dislocation is not known. The purpose of the ARTISAN trial is to compare the clinical and cost-effectiveness of a course of usual care physiotherapy with a single session of physiotherapy and self-management, the ARTISAN intervention. ARTISAN is a UK multi-centre, two-arm, parallel group, randomised controlled trial with 1:1 treatment allocation.

View Article and Find Full Text PDF