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.