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13th February 2011

Author: Cecilie Huth

School: University College Copenhagen, Physiotherapy Skodsborg

Supervisors: Pernille Thomsen Lektor, Physiotherapist, M.Ed;

Annemette Goddokken, Physiotherapist and Performance Stability terapeut;

Contact: Cecilie Huth;


Hypermobility occurs in about 10% of the population. Beightons test is the diagnostic tool that has the greatest usage in assessing hypermobility.

Some hypermobile patients suffers from musculoskeletal pain caused by HM. Evidence is lacking as to why only some patients get chronic pain.

Performance Stability (PS) is a developed diagnostic and treatment concept to be used by physiotherapists and others with interest in muscular problems. PS has not earlier been tested or targeted on patients with hypermobility.


The purpose of the case report is to assess whether stability training using PS can affect the neuromuscular control in hypermobile patients and procure pain relief.


The framework of the paper includes PS as a concept, pain theory and measurements of pain.

Materials and method

A prospective case report of two female hypermobile patients ranging in age from 36-47. Hypermobility is found using Beightons test. The patient are tested positive for instability problems using the PM. The patients were tested pre and post intervention period (2-3 weekly, individual sessions over 4 weeks). Exercises, progression and regression is developed through clinical reasoning.

Ethical considerations

The following principles was used; anonymity-, advantages- and justice principles.


Both patients improved their neuromuscular control and experienced a general reduction in pain from pre-test to post-test. Their subjective evaluation of the course was positive.


Based on the positive test results and ongoing observations it is likely that the concept suitable for hypermobile patients. However it is important to clarify that no conclusions can be made based on this.


The case report indicates that PS can help with pain relief in hypermobile patients but to conclude you would need a large research project; ideally a randomized study on a large population.

If proven, hypermobile patients could receive individual, prescribed and paid physiotherapy to relief pain through a customized exercise plan.

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