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Table 1 Summary – Characteristics of included studies 643 records identified through database searching

From: Physical and mechanical therapies for lower limb symptoms in children with Hypermobility Spectrum Disorder and Hypermobile Ehlers-Danlos Syndrome: a systematic review

Characteristic Pacey et al. (2013) Kemp et al. (2010)
Lower Limb Problem Knee pain of no known aetiology Arthralgia for at least 3 months preceding
Intervention Groups 1. Physiotherapist supervised 8-week physical therapy program, including exercises to address muscle strength and motion control performed into the neutral range of knee extension
2. Physiotherapist supervised 8-week physical therapy program, including exercises to address muscle strength and motion control performed into the full range of knee hyperextension
1. Physiotherapist supervised 6-week generalised physiotherapy programme, aimed at improving muscle strength and fitness
2. Physiotherapist supervised 6-week targeted physiotherapy programme, specifically addressing functional stability of symptomatic joints
N participants 29 57
Age Range 7–16 years 7–16 years
Recruitment Source Children referred to The Children’s Hospital at Westmead’s Physiotherapy, Sports Medicine, Orthopaedic Knee, Connective tissue Dysplasia and Rheumatology clinics (January 2007 – February 2011) Children treated at Alder Hey Children’s Hospital NHS Foundation, Liverpool (June 2004 – May 2007)
Follow-up Period 8 weeks 5 months
Outcomes 1. Pain
 • Child-reported mean knee pain (over one week) (VAS)
 • Parent-reported maximum knee pain (over one week) (Parental-VAS)
2. Patients global impression of change (PGIC)
3. Functional ability (CHAQ) a
4. Quality of life (Child Health Questionnaire)
5. Functional impairment (Mean quadriceps and Hamstring Strength)
6. Functional ability (Number of flights of stairs climbable in 2 min)
1. Pain
 • Improvements in child’s pain assessment score (VAS for > 11 years of age/Wong-Baker Faces < 11 years of age)
 • Parent’s assessment of child’s pain (Parental-VAS)
2. Parents global evaluation of the impact of their child’s hypermobility over the previous week (Global-VAS)
3. Functional Ability (CHAQ)a
4. Functional ability (Six-minute shuttle level assessment) b
  1. aChildhood Health Assessment Questionnaire
  2. bBaseline and midpoint only