Ja Deane

Knowledge and Perceptions of Joint Hypermobility and Joint Hypermobility Syndrome amongst Paediatric Physiotherapists

© 2014 IOS Press and the authors. OBJECTIVES: To explore knowledge and perceptions of Joint Hypermobility (JHM) and Joint Hypermobility Syndrome (JHS) amongst paediatric physiotherapists and to determine training needs. DESIGN: National online survey. SETTING AND PARTICIPANTS: UK paediatric physiotherapists were surveyed through the interactive website of the Chartered Society of Physiotherapy (iCSP). INTERVENTION: A previously validated, self-report questionnaire with minor modifications was distributed nationally via iCSP. RESULTS: Ninety-one questionnaires were completed with representation from all NHS regions. 84% (76/91) of respondents had 6 or more years of experience. Fifty-one percent (46/91) of physiotherapists had received no pre-or post-registration training about JHS. Seventy-nine percent (72/91) were confident in their ability to diagnose JHM, while 54% (49/91) were confident in their ability to diagnose JHS. The physiotherapists had better knowledge of the articular features than the non-articular features of JHS with mean knowledge scores of 63.8% and 54.7% respectively. Eighty percent (73/91) of physiotherapists perceived JHS to have significant impact on quality of life. Education and reassurance, home exercises, proprioception, closed chain exercises, postural education and orthotics, were perceived by more than 80% respondents as effective. Ninety-seven percent (88/91) indicated a need for continuing professional development (CPD) training. CONCLUSIONS: The majority of respondents considered JHS to impact significantly on quality of life. Participants had greater confidence in diagnosing JHM than JHS and had better knowledge of the articular features than the non-articular features of JHS. Results suggest that undergraduate and CPD education is required to facilitate greater understanding of the assessment and management of this multi-system condition.

A study of UK physiotherapists’ knowledge and training needs in hypermobility and hypermobility syndrome

A study of UK physiotherapists’ knowledge and training needs in Hypermobility and Hypermobility Syndrome Lyell, M.J., Simmonds, J.V. c, & Deane, J.A. aUniversity of Hertfordshire, School of Health and Human Social Work, Hatfield, UK. b University College London, Institute of Child Health, London, UK: c Hospital of St John and St Elizabeth, Hypermobility Unit, London, UK. d Imperial College London, MSK Lab, School of Medicine, London, UK.

Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK-based assessment guidelines with regard to recurrent LDDD; there are, however, inconsistencies in the management approaches supported. This reflects the current literature and the lack of specific, formalised guidance. LDDD treatment stratification and further research are explicitly supported.