Short-term effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a randomised controlled trial

Review written by Dr Travis Pollen info

Key Points

  1. There is no gold standard treatment for hypermobility spectrum disorder and persistent shoulder symptoms. This randomized controlled trial compared the short-term effect of high-load exercise with low-load exercise (i.e. standard care) on self-reported function in patients with hypermobile shoulders.
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BACKGROUND & OBJECTIVE

80% of individuals with hypermobility spectrum disorder (HSD) experience symptoms in their shoulders including instability, pain, and disability. For these individuals there is no gold standard treatment. Because they often have deficits in strength, stability, and tendon stiffness, high-load strengthening exercise may offer substantial functional benefits (1). However, many clinicians default to low-load exercise because they believe it is safer.

The purpose of this randomized controlled trial was to compare the short-term effect of high-load exercise with low-load exercise (i.e. standard care) on self-reported function in patients with hypermobile shoulders. To achieve a clinically significant difference, the authors hypothesized that high load would be superior to low load by 12%.

80% of individuals with hypermobility spectrum disorder experience symptoms in their shoulders including instability, pain, and disability.
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Contrary to prevailing belief among many clinicians, high-load exercise is safe for patients with HSD.

METHODS

100 patients with HSD (79 females, 21 males; age = 38 ± 13 years, Beighton score = 5.8 ± 1.7, average symptom duration = 3 years) were randomly allocated to either a high-load or low-load group for 16 weeks. The

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