Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
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
_version_ 1784881600772702208
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
work_keys_str_mv AT russekleslien presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT blocknancyp presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT byrneelaine presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT chalelasusan presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT chancliffton presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT comerfordmark presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT frostnicole presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT hennesseysharon presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT mccarthyann presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT nicholsonlesliel presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT parryjason presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT simmondsjane presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT stottpatriciaj presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT thomaslucy presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT treleavenjulia presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT wagnerwendy presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations
AT hakimalan presentationandphysicaltherapymanagementofuppercervicalinstabilityinpatientswithsymptomaticgeneralizedjointhypermobilityinternationalexpertconsensusrecommendations