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- Open Access
The efficacy and cost effectiveness of a multidisciplinary intervention strategy for the treatment of benign joint hypermobility syndrome (BJHS) in childhood. a randomised, single centre parallel group trial. (The bendy study)
https://doi.org/10.1186/1546-0096-12-S1-P58
© Bale et al; licensee BioMed Central Ltd. 2014
- Published: 17 September 2014
Keywords
- Standard Care
- Case Definition
- Musculoskeletal Pain
- Standard Management
- Pain Reduction
Introduction
Joint hypermobility is common in childhood and can be associated with musculoskeletal pain and dysfunction. Current management is delivered by a multidisciplinary team but evidence of efficacy is limited.
Objectives
This clinical trial aimed to determine whether a structured multidisciplinary intervention resulted in improved clinical outcomes compared with standard care
Methods
A prospective randomised, single centre parallel group trial comparing an 8-week individualised multidisciplinary intervention programme with current standard management (advice and a physiotherapy appointment). Children and young people (CYP) were assessed for pain, function, coordination and strength at baseline, 3 and 12 months.
Results
Table 1
Baseline score (SD) | Rate of change over 12 months (95% CI) | ||||
|---|---|---|---|---|---|
Outcome variable | Intervention group | Control | |||
Child pain assessment (0-5, zero is the best), n=103 | 2.31 (1.55) | -1.42 | (-1.78 to -1.06) | -1.31 | (-1.75 to -0.85) |
Parent observed pain assessment (0-100 VAS, zero is the best) n=105 | 35.90 (26.46) | -6.09 | (12.90 to 0.73) | -6.22 | (-13.62 to 1.18) |
Child health assessment questionanire (CHAQ) (0-3, zero is the best), n=104 | 0.82 (0.63) | +0.02 | (-0.12 to 0.16) | -0.03 | (-0.13 to 0.64) |
Child health 9 dimensional utility (CHU9D) (0-1, zero is the worst), n=104 | 0.85 (0.11) | +0.02 | (-0.01 to 0.04) | +0.002 | (-0.02 to 0.03) |
Movement assessment battery for children (M-ABC) (0-100, zero is theworst), n =104 | 34.56 (28.61) | +2.60 | (-2.92 to 8.11) | +8.51 | (3.17 to 13.86) |
Grip Strength (Dynamometer), n=104 | 57.29 (28.30) | +4.55 | (0.16 to 8.94) | +6.75 | (2.85 to 10.66) |
Conclusion
This is the first RCT to compare a structured multidisciplinary intervention with standard care in symptomatic childhood hypermobility. The study demonstrates significant improvement among subjects but no additional benefit from targeted intervention. The findings emphasise the benefit of information and physiotherapy, but highlight the difficulty in demonstrating subtle benefit from specific interventions without better tools for case definition and outcomes assessment.
Trial registration identifying number
UKCRN Portfolio 9366.
Disclosure of interest
None declared.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
