- Title
- Assessment and management of children and adolescents with symptomatic hypermobility
- Creator
- Maarj, Muhammad
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2024
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Hypermobility Spectrum Disorder (HSD) and hypermobile Ehlers-Danlos Syndrome (hEDS) collectively describe symptomatic hypermobility (SH), a condition in which individuals with joint hypermobility present with arthralgia, joint instability and/or soft tissue injury, and may also be associated with a broad range of systemic comorbidities. Subsequent chronic pain and functional impairment can significantly impact activity participation and reduce quality of life. Despite this, currently there is a paucity of data available on the assessment of children with generalised and symptomatic joint hypermobility with limited clinical research on the most effective management strategies for this paediatric population. Therefore, the primary aim of this thesis is to address gaps in knowledge and research related to assessment and management of children with joint hypermobility associated with lower limb symptoms. Study one contributed new knowledge on the biomechanical profile of children with generalised joint hypermobility (GJH) and demonstrated variations in hip, knee, ankle and foot range of motion not assessed in the Beighton score. Study two confirmed the importance of pain, fatigue, function and quality of life outcomes for the development of a minimum core set of condition-specific outcome measurement tools for children with SH of the lower extremities. Study three validated a novel mHealth tool for pain reporting to facilitate timely access to self reported pain data in real-time and improve clinician implementation of appropriate treatment approaches for children with SH. Study four investigated the safety and efficacy of custom-in shoe orthotics in children with SH and demonstrated application of the validated instrument from study three to measure pain intensity. This study demonstrates reduced pain and improved quality of life of children with SH in the short-term, and further highlights the role of the podiatrists as an integral part of the multidisciplinary management team for this paediatric population. In summary, the findings of this thesis provide a valuable insight into assessment and management of lower limb problems in children with GJH and SH. These include: i) identification of biomechanical differences in children with GJH compared to healthy peers; ii)the first evidence-based review of interventional clinical outcomes assessing change over time for children with SH; iii) the first study to validate a novel electronic tool for pain measurement in children diagnosed with SH which is as valid as the traditional paper version; iv) the first interventional trial of custom-made orthotics for children with SH and lower limb pain over a 3-month time period, with evaluation of function as well as quality of life. The outcomes of this thesis will support clinicians, particularly podiatrists, but also the wider multidisciplinary team and form a foundation for future research with children diagnosed with GJH and SH that suffer with lower limb symptoms.
- Subject
- hypermobile; hypermobility; musculoskeletal; lower limb; podiatrist; hypermobile Ehlers-Danlos Syndrome (hEDS); pediatrics; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1514822
- Identifier
- uon:56859
- Rights
- Copyright 2024 Muhammad Maarj
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 17 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 368 KB | Adobe Acrobat PDF | View Details Download |