{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:08:51Z","timestamp":1753862931428,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>A 16\u2010year\u2010old male with hypermobility spectrum disorder (HSD) and Raynaud's phenomenon (RP) was referred to a clinical exercise physiologist (CEP) by their pediatric rheumatologist. The patient presented with arthralgia in the left knee and shoulder. Specifically, the left knee presented discomfort during activities of daily living (ADL), and the left shoulder had a reduced range of motion resulting from pain. Finally, complaints of painful fingers were also significant due to increased RP flare\u2010ups during winter. A posture analysis was conducted, indicating relatively poor posture. Range of motion and manual muscle testing were suboptimal in the shoulders, but optimal in the knees and hips. The Kendal test, patella compression test, and Clarke's sign were conducted due to knee pain. Functional tests included a pelvic bridge, squat, Neer's test, and wall push\u2010up. Finally, the modified pediatric clinical test of sensory interaction in balance (mPCTSIB) was completed to determine the interaction between balance systems. Analysis of all the tests conducted above confirmed the diagnosis of HSD and also indicated scapula dyskinesia, supraspinatus impingement, and patellofemoral pain syndrome. Consequently, the CEP treatment focused on strengthening the foot, knee, and hip kinetic chain, as a 12\u2010week home program, along with hand exercises as needed to aid in the pain and stiffness experienced during RP flare\u2010ups. The physiotherapist treatment was more hands on in the use of myofascial release, electrotherapy, taping, and posture correction of the neck and shoulder over four in\u2010house visits. Finally, a 6\u2010month follow\u2010up was conducted by the CEP, in which the patient showed improvement with a pain\u2010free range of motion and the ability to optimally conduct ADLs.<\/jats:p>","DOI":"10.1002\/ccr3.9678","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T04:30:00Z","timestamp":1733891400000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multidisciplinary Approach to Hypermobility Spectrum Disorder, Raynaud's Phenomenon, and Biomechanical Soft Tissue Injuries in an Adolescent Boy: A Case Report"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6109-7940","authenticated-orcid":false,"given":"Su\u2010an\u00e9","family":"Zwiegelaar","sequence":"first","affiliation":[{"name":"Division of Movement Science and Exercise Therapy, Department of Sport Science, Faculty of Medicine and Health Sciences Stellenbosch University  Stellenbosch South Africa"},{"name":"The Movement Laboratory, Sport Science Department, Faculty of Medicine and Health Sciences Stellenbosch University  Stellenbosch South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepthi R.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg, Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Roman","sequence":"additional","affiliation":[{"name":"Olivia Roman Physiotherapists  Kuilsriver Western Cape South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen E.","family":"Welman","sequence":"additional","affiliation":[{"name":"Division of Movement Science and Exercise Therapy, Department of Sport Science, Faculty of Medicine and Health Sciences Stellenbosch University  Stellenbosch South Africa"},{"name":"The Movement Laboratory, Sport Science Department, Faculty of Medicine and Health Sciences Stellenbosch University  Stellenbosch South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/80.4.386"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.02.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2014.01.009"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010018\u20100302\u20101"},{"issue":"8","key":"e_1_2_9_6_1","first-page":"13","article-title":"Hypermobile Ehlers\u2010Danlos Syndrome and Hypermobility Spectrum Disorders","volume":"103","author":"Yew K. 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