ArticleFrontiers in medicine2022
Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations.
Article in Frontiers in medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- An Overview of Vascular Compression Syndromes and Associations with Autonomic Dysfunction: A Review.Biomedicines · 2026Review
- Characterizing Initial Cervical Spine and Neurovascular Findings in 84 Consecutive Patients with Hypermobile Ehlers-Danlos Syndrome: A Retrospective Study.Journal of clinical medicine · 2026Article
- Cervical Oculopathy: The Cervical Spine Etiology of Visual Symptoms and Eye Diseases-A Hypothesis Exploring Mechanisms Linking the Neck and the Eye.Diagnostics (Basel, Switzerland) · 2025Article
- Review
- The effects of C2 instability on cervical curvature changes and clinical outcomes after sub-axial cervical expansive door-open laminoplasty.Frontiers in surgery · 2025Article
- Differentiating the Structural and Functional Instability of the Craniocervical Junction.Healthcare (Basel, Switzerland) · 2024Review
- Article
- Present but Ignored: Physical Condition and Health-Related Quality of Life in College-Aged Females with Generalized Joint Hypermobility.Healthcare (Basel, Switzerland) · 2024Article
- The ligamentous cervical instability etiology of human disease from the forward head-facedown lifestyle: emphasis on obstruction of fluid flow into and out of the brain.Frontiers in neurology · 2024Article
- Co-occurrence of tethered cord syndrome and cervical spine instability in hypermobile Ehlers-Danlos syndrome.Frontiers in neurology · 2024Article
- Presentation and physical therapy management using a neuroplasticity approach for patients with hypermobility-related upper cervical instability: a brief report.Frontiers in neurology · 2024Article
- Headache disorders in patients with Ehlers-Danlos syndromes and hypermobility spectrum disorders.Frontiers in neurology · 2024Review
- Neuraxial biomechanics, fluid dynamics, and myodural regulation: rethinking management of hypermobility and CNS disorders.Frontiers in neurology · 2024Review
- Application of biomechanical principles to upper cervical spine anatomy to alleviate symptoms of intermittent cranial nerve IX irritation. Directions for successful self-management of headache post-concussion? A case series.The Journal of manual & manipulative therapy · 2023Article
- A Clinical Qualification Protocol Highlights Overlapping Genomic Influences and Neuro-Autonomic Mechanisms in Ehlers-Danlos and Long COVID-19 Syndromes.Current issues in molecular biology · 2023Article
- Brain-based symptoms reported in young adults evaluated for cervical spine etiology: a retrospective, cross-sectional clinical study with preliminary data on over 200 patients.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
17 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Experts in symptomatic generalized joint hypermobility (S-GJH) agree that upper cervical instability (UCI) needs to be better recognized in S-GJH, which commonly presents in the clinic as generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome. While mild UCI may be common, it can still be impactful; though considerably less common, severe UCI can potentially be debilitating. UCI includes both atlanto-occipital and atlantoaxial instability. In the absence of research or published literature describing validated tests or prediction rules, it is not clear what signs and symptoms are most important for diagnosis of UCI. Similarly, healthcare providers lack agreed-upon ways to screen and classify different types or severity of UCI and how to manage UCI in this population. Consequently, recognition and management of UCI in this population has likely been inconsistent and not based on the knowledge and skills of the most experienced clinicians. The current work represents efforts of an international team of physical/physiotherapy clinicians and a S-GJH expert rheumatologist to develop expert consensus recommendations for screening, assessing, and managing patients with UCI associated with S-GJH. Hopefully these recommendations can improve overall recognition and care for this population by combining expertise from physical/physiotherapy clinicians and researchers spanning three continents. These recommendations may also stimulate more research into recognition and conservative care for this complex condition.
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