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Diagnosis, management and assessment of adults with joint hypermobility syndrome: A UK-wide survey of physiotherapy practice

Palmer, Shea; Cramp, Fiona (Alice); Lewis, Rachel; Muhammad, Shahid; Clark, Emma


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Shea Palmer
Occasional Associate Lecturer - CHSS - HSW

Fiona Cramp
Professor in Long Term Conditions

Rachel Lewis

Shahid Muhammad

Emma Clark


Purpose: This study aimed to identify how Joint Hypermobility Syndrome (JHS) is diagnosed, managed and assessed in routine physiotherapy practice.
Relevance: JHS is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. Symptomatic joint hypermobility has been reported to affect approximately 5% of women and 0.6% of men. Although it is a relatively common cause of musculoskeletal pain it is generally understood to be under-recognised and poorly managed in clinical practice.
Participants: Paper copies of the survey were sent to 201 randomly selected secondary care organisations across the United Kingdom (UK) and an electronic version was advertised through physiotherapy professional networks.
Methods: Successive drafts of the survey tool were developed from similar physiotherapy surveys of musculoskeletal practice, a review of the literature, and consultation with researchers and clinicians before being finalised.
Analysis: Results were analysed and presented using descriptive statistics.
Results: A total of 66 responses (80% women) were received from physiotherapists with a wide range of clinical experience. 68% of respondents reported that they had not received any formal training in JHS management. 69% of respondents reported not using the recommended Brighton diagnostic criteria for JHS. The stated aims of physiotherapy and the specific interventions employed seemed well matched, with a focus on advice, education, exercise and self-management. Although pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, suggesting a mismatch between what clinicians aim to achieve and what they measure.
Conclusions: The results suggest that reported management strategies are broadly appropriate to long term musculoskeletal conditions but that additional training specific to JHS may be required, particularly in relation to diagnosis and assessment.
Implications: Further education and training may be required for physiotherapists to adequately recognise, diagnose, manage and assess JHS.


Palmer, S., Cramp, F. (., Lewis, R., Muhammad, S., & Clark, E. (2014, October). Diagnosis, management and assessment of adults with joint hypermobility syndrome: A UK-wide survey of physiotherapy practice. Poster presented at Physiotherapy UK 2014, Birmingham, UK

Presentation Conference Type Poster
Conference Name Physiotherapy UK 2014
Conference Location Birmingham, UK
Start Date Oct 10, 2014
End Date Oct 11, 2014
Publication Date Oct 10, 2014
Publicly Available Date Jun 6, 2019
Peer Reviewed Peer Reviewed
Keywords joint hypermobility syndrome
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Additional Information Title of Conference or Conference Proceedings : Physiotherapy UK 2014