Diagnosis, Management and Assessment of Adults with Joint Hypermobility Syndrome

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 usually understood to be under-recognized and poorly managed in clinical practice. For this reason, this study sought 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 organizations 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 broad 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 frequently used (only 31% of respondents). The stated aims of physiotherapy and the specific interventions employed appear to be well matched, with a focus on advice, education, exercise and self-management. While pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, indicating a mismatch between what clinicians aim to achieve and what they measure. The results indicate that reported management strategies are broadly appropriate to long-term musculoskeletal conditions but additional training specific to JHS may be required, especially in diagnosis and assessment.

Knee Assessment and Hip Mechanics

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