hypermobility syndrome eds iii n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
HYPERMOBILITY SYNDROME/EDS III PowerPoint Presentation
Download Presentation
HYPERMOBILITY SYNDROME/EDS III

Loading in 2 Seconds...

play fullscreen
1 / 24

HYPERMOBILITY SYNDROME/EDS III - PowerPoint PPT Presentation


  • 130 Views
  • Uploaded on

HYPERMOBILITY SYNDROME/EDS III. LORRAINE FRIEL EXTENDED SCOPE PRACTITIONER CENTRE FOR RHEUMATIC DISEASES GLASGOW ROYAL INFIRMARY.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'HYPERMOBILITY SYNDROME/EDS III' - obelia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
hypermobility syndrome eds iii

HYPERMOBILITY SYNDROME/EDS III

LORRAINE FRIEL

EXTENDED SCOPE PRACTITIONER

CENTRE FOR RHEUMATIC DISEASES

GLASGOW ROYAL INFIRMARY

hypermobility hypermobility syndrome
Range of movement in excess of the accepted normal range of motion at a joint, taking into account the age, gender and ethnic background of the individual (Grahame 2010)

Musculoskeletal symptoms in the presence of generalised joint hypermobility but in the absence of other defined rheumatic diseases (Kirk et al 1967)

HYPERMOBILITY & HYPERMOBILITY SYNDROME
what is joint hypermobility syndrome
What is joint hypermobility syndrome?

Pereception of JHS as a mild or trivial condition with lax joints, pain, joint dislocation/subluxation, possible OA in later life.

This has changed…..

Now considered an inherited, genetically determined multisystemic disorder of connective tissues rendering them more vulnerable to injury and mechanical failure.

what is hms
WHAT IS HMS?
  • A family of related genetically based conditions. The protein affected varies and the degree of difference varies
  • Marfans Syndrome
  • Ehlers-danlos
  • Benign Joint Hypermobility syndrome
presentation
Presentation
  • Chronic pain and kinesiophobia
  • Joint laxity,subluxations/dislocations
  • Vulnerability to injury
  • Rest at EOR/”lock” joints and poor posture habits
  • Dysfunctional movement patterns
  • Poor healing and slower recovery
  • Easy bruising and tendency towards bleeding
non articular presentation
Non articular presentation
  • Fatigue
  • Deconditioning
  • Autonomic dysfunction
  • Pelvic organ prolapse
  • Urinary incontinence
  • Psychological
  • POTS
examination
Examination
  • Observation – skin, postural alignment
  • Range of movement
  • Functional activities
  • Muscle testing
  • Neurological testing
  • Passive movement
  • Ligament integrity
  • Balance/proprioception
good postural alignment
Muscular and skeletal balance which protects the supporting structures against injury and progressive deformity

Muscles function most efficiently

Optimum positions for thoracic and abdominal organs

Good postural alignment
habitual postures
Frequently rest at EOR and poor postural alignment

Stress and strain in HM collagenous tissues

Decreased muscle use leading to stiffness, weakness, deconditioning, fatigue

Habitual postures
active movement
Look well

Move well

Subjective and objective often at odds

Check ‘normal’ range for that patient

Active movement
assess muscle function
Assess muscle function
  • Breathing
  • Transversus abdominus
  • Deep multifidus
  • Pelvis floor
  • Timing, atrophy, loss of tonic function, loss of co-ordination, asymmetry, length
  • Overactivity in globa, muscles – quads, latissimus, pects, obliques, erector spinae
muscle strategy
Muscle strategy
  • High load strategy for low load task
  • Produces excessive compression, loss of mobility, loss of shock absorbtion
  • Tendency to rely on ‘ankle strategy’ to maintain balance
functional movement testing
Functional movement testing
  • One leg stand
  • Standing knee bend
  • Walking
  • Heel raise
  • Sit to stand
management
Management
  • Time – listen to story, answer questions, identify needs/expectations, address fears/barriers
  • Communication – greater benefit and cost effectiveness when patients who expressed apreference received their preferred treatment
  • Reassurance – finally have diagnosis, not life threatening, can be proactive
prioritise treatment
Prioritise treatment
  • Try to avoid chasing the pain
  • Patients expectations
  • Short and long term goals
  • Achievable
  • Enjoyable
treatments
Treatments
  • Supports
  • Tape
  • Pre-exercising readiness – breathing, relaxation, pain relieving modalities, manual therapy, posture re education
correct movement dysfunction
Correct movement dysfunction
  • Start in non weight bearing, pain free positions
  • Closed chain
  • Improve joint positioning and awareness
joint stability and control
Joint stability and control

Challenge stability

Improve balance and coordination

  • Incorporate into weightbearing and functional positions
  • Introduce unpredictability using balance boards, wobble cushions, gym ball
stretching
Stretching
  • Often advised not to stretch –danger of overstretching/damage

Reassure and educate – good to stretch

  • Maintain muscle length, joint range, stretch out old injuries and muscle spasm
  • No stretching beyond their hypermobile range
education
Education
  • Be positive
  • Joint care – avoidance of unhelpful postures and activities
  • Pacing
  • Discuss lifestyle modifications – occupation, family life, sport, pregnancy and other health issues
general fitness
General fitness
  • Encourage lifelong commitment to exercise and maintenance of good general fitness
  • Encourage normal activities and return to sport
  • Pilates, yoga, exercise in water, walking
main aim of treatment
Main aim of treatment
  • Increase function
  • Decrease disability
  • Self management

Treatment often takes longer(many affected areas, longer healing time, mismanaged in past)

Complete resolution rarely occurs

contacts resources
Contacts/resources
  • www.hypermobility.org
  • www.ehlers-danlos.org
  • www.arthritisresearchuk.org