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

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

Abstract

Joint Hypermobility Syndrome (JHS) is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. It is a relatively common cause of musculoskeletal pain but is generally understood to be under-recognised and poorly managed in clinical practice. This study therefore aimed to identify how JHS is diagnosed, managed and assessed in routine physiotherapy practice. A survey tool was developed from similar physiotherapy surveys of musculoskeletal practice, a review of the literature, and consultation with researchers and clinicians. Paper copies of the final survey were sent to 201 randomly selected secondary care organisations across the UK and an electronic version was advertised through physiotherapy professional networks. A total of 66 responses (80% women) were received from physiotherapists with a wide range of clinical experience. Only 32% of respondents reported that they had received formal training in JHS management. The Brighton diagnostic criteria for JHS were not often used (only 31% of respondents). The stated aims of physiotherapy and the specific interventions employed seem 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. The results suggest that reported management strategies are broadly appropriate to long term musculoskeletal conditions but additional training specific to JHS may be required, particularly in diagnosis and assessment.

Citation

Palmer, S., Cramp, F. (., Lewis, R., Muhammad, S., & Clark, E. (2015). Diagnosis, management and assessment of adults with joint hypermobility syndrome: A UK-wide survey of physiotherapy practice. Musculoskeletal Care, 13(2), 101-111. https://doi.org/10.1002/msc.1091

• Journal Article Type: Article
• Publication Date: Jun 1, 2015
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 2
• Pages: 101-111
• DOI: https://doi.org/10.1002/msc.1091
• Keywords: joint hypermobility, physiotherapy, survey
• Public URL: https://uwe-repository.worktribe.com/output/833771
• Publisher URL: http://dx.doi.org/10.1002/msc.1091
• Additional Information: Additional Information : First published online 18 March 2015. This is the accepted version of the following article: Palmer, S., Cramp, F. A., Lewis, R., Muhammad, S. and Clark, E. (2015) Diagnosis, management and assessment of adults with joint hypermobility syndrome: A UK-wide survey of physiotherapy practice. Musculoskeletal Care, 13 (2). pp. 101-111. ISSN 1478-2189, which has been published in final form at http://dx.doi.org/10.1002/msc.1091