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Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations
Experts in symptomatic generalized joint hypermobility (S-GJH) agree that upper cervical instability (UCI) needs to be better recognized in S-GJH, which commonly presents in the clinic as generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome. While mild UCI may be common...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893781/ https://www.ncbi.nlm.nih.gov/pubmed/36743665 http://dx.doi.org/10.3389/fmed.2022.1072764 |
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author | Russek, Leslie N. Block, Nancy P. Byrne, Elaine Chalela, Susan Chan, Cliffton Comerford, Mark Frost, Nicole Hennessey, Sharon McCarthy, Ann Nicholson, Leslie L. Parry, Jason Simmonds, Jane Stott, Patricia J. Thomas, Lucy Treleaven, Julia Wagner, Wendy Hakim, Alan |
author_facet | Russek, Leslie N. Block, Nancy P. Byrne, Elaine Chalela, Susan Chan, Cliffton Comerford, Mark Frost, Nicole Hennessey, Sharon McCarthy, Ann Nicholson, Leslie L. Parry, Jason Simmonds, Jane Stott, Patricia J. Thomas, Lucy Treleaven, Julia Wagner, Wendy Hakim, Alan |
author_sort | Russek, Leslie N. |
collection | PubMed |
description | Experts in symptomatic generalized joint hypermobility (S-GJH) agree that upper cervical instability (UCI) needs to be better recognized in S-GJH, which commonly presents in the clinic as generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome. While mild UCI may be common, it can still be impactful; though considerably less common, severe UCI can potentially be debilitating. UCI includes both atlanto-occipital and atlantoaxial instability. In the absence of research or published literature describing validated tests or prediction rules, it is not clear what signs and symptoms are most important for diagnosis of UCI. Similarly, healthcare providers lack agreed-upon ways to screen and classify different types or severity of UCI and how to manage UCI in this population. Consequently, recognition and management of UCI in this population has likely been inconsistent and not based on the knowledge and skills of the most experienced clinicians. The current work represents efforts of an international team of physical/physiotherapy clinicians and a S-GJH expert rheumatologist to develop expert consensus recommendations for screening, assessing, and managing patients with UCI associated with S-GJH. Hopefully these recommendations can improve overall recognition and care for this population by combining expertise from physical/physiotherapy clinicians and researchers spanning three continents. These recommendations may also stimulate more research into recognition and conservative care for this complex condition. |
format | Online Article Text |
id | pubmed-9893781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98937812023-02-03 Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations Russek, Leslie N. Block, Nancy P. Byrne, Elaine Chalela, Susan Chan, Cliffton Comerford, Mark Frost, Nicole Hennessey, Sharon McCarthy, Ann Nicholson, Leslie L. Parry, Jason Simmonds, Jane Stott, Patricia J. Thomas, Lucy Treleaven, Julia Wagner, Wendy Hakim, Alan Front Med (Lausanne) Medicine Experts in symptomatic generalized joint hypermobility (S-GJH) agree that upper cervical instability (UCI) needs to be better recognized in S-GJH, which commonly presents in the clinic as generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome. While mild UCI may be common, it can still be impactful; though considerably less common, severe UCI can potentially be debilitating. UCI includes both atlanto-occipital and atlantoaxial instability. In the absence of research or published literature describing validated tests or prediction rules, it is not clear what signs and symptoms are most important for diagnosis of UCI. Similarly, healthcare providers lack agreed-upon ways to screen and classify different types or severity of UCI and how to manage UCI in this population. Consequently, recognition and management of UCI in this population has likely been inconsistent and not based on the knowledge and skills of the most experienced clinicians. The current work represents efforts of an international team of physical/physiotherapy clinicians and a S-GJH expert rheumatologist to develop expert consensus recommendations for screening, assessing, and managing patients with UCI associated with S-GJH. Hopefully these recommendations can improve overall recognition and care for this population by combining expertise from physical/physiotherapy clinicians and researchers spanning three continents. These recommendations may also stimulate more research into recognition and conservative care for this complex condition. Frontiers Media S.A. 2023-01-18 /pmc/articles/PMC9893781/ /pubmed/36743665 http://dx.doi.org/10.3389/fmed.2022.1072764 Text en Copyright © 2023 Russek, Block, Byrne, Chalela, Chan, Comerford, Frost, Hennessey, McCarthy, Nicholson, Parry, Simmonds, Stott, Thomas, Treleaven, Wagner and Hakim. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Russek, Leslie N. Block, Nancy P. Byrne, Elaine Chalela, Susan Chan, Cliffton Comerford, Mark Frost, Nicole Hennessey, Sharon McCarthy, Ann Nicholson, Leslie L. Parry, Jason Simmonds, Jane Stott, Patricia J. Thomas, Lucy Treleaven, Julia Wagner, Wendy Hakim, Alan Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title | Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title_full | Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title_fullStr | Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title_full_unstemmed | Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title_short | Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations |
title_sort | presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: international expert consensus recommendations |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9893781/ https://www.ncbi.nlm.nih.gov/pubmed/36743665 http://dx.doi.org/10.3389/fmed.2022.1072764 |
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