The OT Role in Paediatric Hypermobility

Occupational Therapy (OT) plays a key role in managing paediatric joint hypermobility, particularly in conditions like Paediatric Generalised Joint Hypermobility (pGJH), Paediatric Generalised Hypermobility Spectrum Disorders (pgHSD), Loeys-Dietz Syndrome (LDS), Marfan Syndrome, and Stickler Syndrome. The primary focus is on improving functional independence, joint stability, and pain management while preventing fatigue and injury.

Occupational Therapy Role in Joint Hypermobility Management

1. Strengthening & Stability Training

💪🏼 Encouraging low-impact strengthening activities (e.g., core, shoulder girdle, and hand muscles) to improve postural control and reduce excessive joint movement.

💪🏼 Proprioceptive activities (e.g., weight-bearing exercises, therapy ball exercises) to enhance joint awareness and stability.

2. Fine & Gross Motor Skill Development

✍ Handwriting support (adapted grips, slanted surfaces, ergonomic pens) to reduce hand fatigue.

✂️ Modifying scissor skills, dressing tasks, and tool use to accommodate reduced grip strength and joint instability.

🛝 Working on balance and coordination to improve walking, stair navigation, and playground activities.

3. Pain & Fatigue Management

⏯️ Energy conservation strategies (e.g., pacing, rest breaks, task modification).

🪑 Recommending assistive devices (splints, braces, ergonomic seating)

➡️ Referring to other providers (e.g., podiatry for lower limb assessment, physio, speech, dietetics)

😮‍💨 Teaching pain, fatigue and general self-management strategies

4. Activity Modification & Adaptations

🍽️ Environmental and task modifications at school and home (adjusting seating, using pencil grips, adapted cutlery).

🪑  Alternative positioning (e.g., using cushions, footrests) to support posture.

🎾 Adaptive play strategies to encourage participation in age-appropriate activities.

5. Education & Self-Management

🎒 Teaching joint protection techniques (avoiding hyperextension, using larger joints for heavy tasks).

⏰ Encouraging self-awareness and pacing to prevent overuse injuries.

🧑‍🧑‍🧒 Providing guidance to parents and teachers on how to support the child’s needs.

Example: Paediatric Occupational Therapy Approach for LDS & Severe Joint Hypermobility

For a 5-year-old girl with Loeys-Dietz Syndrome, OT intervention would be highly individualised and focus on:

💚 Preventing injuries due to hypermobility and vascular concerns.

🩵 Enhancing daily function in self-care, play, and school activities.

💛 Educating the child and their family and caregivers about LDS.

💜 Reducing fatigue and pain through pacing and activity modifications.

🩷 Collaborating with other professionals (physiotherapists, orthotists, educators) for a holistic approach.