Does Joint Hypermobility Alter Response To FIT Teens In Adolescents With Fibromyalgia? A Case Study

Symptomatic joint hypermobility (JH) conditions are often underdiagnosed, disabling, and commonly co-occur with juvenile fibromyalgia (JFM).1 The FIT Teens program combines cognitive-behavioral therapy and neuromuscular training for JFM pain management. PURPOSE: To evaluate the responsiveness of a participant with JFM and JH to FIT Teens evidenced by changes to biomechanical, strength, and psychosocial contributors to pain. METHODS: This is a retrospective analysis of patient-reported measures (Table) and biomechanical data collected at baseline and after FIT Teens program completion from a participant with JFM and JH (Beighton score 6/9).2 Landing/jumping task data were collected using a 3D motion capture system and knee strength via isokinetic dynamometry. RESULTS: The large increase in knee abduction and slight decrease in knee flexion angles post-intervention (Fig 1), suggests that the increased maximum depth of center of mass (Table 1) was achieved through more frontal than sagittal plane knee motion—a less safe movement pattern. Despite this altered movement strategy, increased knee extension strength with reduced disability, pain, and kinesiophobia was evidenced (Table 1). CONCLUSION: Patient-reported outcomes and strength improved, but landing/jumping biomechanics showed a riskier movement pattern. Reduced pain and kinesiophobia may have encouraged a more confident yet exploratory movement strategy. Future research should explore if biopsychosocial profiles predict response to movement programs and if tailored and additional training can better support those with both JH and JFM. Supported by: This work was supported by the National Institutes of Health [R01 AR070474 and P30 AR076316] and the Ehlers Danlos Society, New York, NY. Tessa Hulburt, PhD, is supported by the Emory Health Services Research Center Training Grant [T32 HS029585].