Shoulder Strength, Wrist Stabilizing Exercise and Hand Orthoses in Hypermobility: Evidence From Two Randomized Trials

Physical therapists, physical therapist assistants working under the direction and supervision of a physical therapist, and certified hand therapists who see adults with hypermobility spectrum disorder or hypermobile Ehlers-Danlos syndrome presenting with shoulder, wrist or hand symptoms.

Physical therapists, physical therapist assistants, certified hand therapists, and occupational therapists involved in upper-limb rehabilitation for people with hypermobility.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of two peer-reviewed studies and adds no claims beyond them.

Christensen T, Juhl CB, Juul-Kristensen B, Skou ST, Søndergaard J, Søgaard K, Liaghat B. Association Between Changes in Shoulder Strength and Self-Reported Shoulder Symptoms in Patients With Hypermobility Following 16-Weeks of High-Load or Low-Load Exercise: A Secondary Analysis of an RCT. Physiother Res Int. 2026;31(2):e70197. doi:10.1002/pri.70197

Susanne L, Lisbeth C. Wrist Stabilising Exercise Versus Hand Orthotic Intervention for Persons with Hypermobility – A Randomised Clinical Trial. Clin Rehabil. 2025;39(1):47-57. doi:10.1177/02692155241293265

After completing this course, you will be able to:

1. Describe who was studied in the secondary analysis of the shoulder exercise trial and in the wrist stabilizing exercise trial, and what question each study set out to answer.
2. State how changes in shoulder strength related to self-reported shoulder function, pain and perceived improvement after 16 weeks of high-load or low-load exercise, as reported by the secondary analysis.
3. Distinguish what the wrist trial reported when it compared stabilizing exercise with a hand orthosis from what the shoulder analysis reported, including where the two papers diverge and what each set of authors concluded.

1. Start Here: How This Course Works
2. Part One: Shoulder Strength Changes and Symptoms in Hypermobility Spectrum Disorder
3. Who Took Part: Adults With Hypermobility and Persistent Shoulder Symptoms
4. How Strength and Symptoms Were Measured Across 16 Weeks
5. What the Analysis Found for Function, Pain and Perceived Improvement
6. What the Authors Concluded and Where the Analysis Falls Short
7. Part Two: Wrist Stabilizing Exercise Compared With a Hand Orthosis
8. Who Was Enrolled and What Brought Them In
9. The Two Twelve-Week Interventions and How They Were Compared
10. What Changed in Activity Ability, Hand Function, Grip Strength and Symptoms
11. Missing Data, Blunt Instruments and the Authors' Conclusion
12. Bringing It Together: Strengthening and Support Across the Upper Limb
13. Where the Two Studies Point the Same Way
14. Where the Findings Diverge and Which Study Reported What
15. What This Could Mean in Upper-Limb Practice
16. Open Questions the Two Studies Leave Behind
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Christensen T, Juhl CB, Juul-Kristensen B, Skou ST, Søndergaard J, Søgaard K, Liaghat B. Association Between Changes in Shoulder Strength and Self-Reported Shoulder Symptoms in Patients With Hypermobility Following 16-Weeks of High-Load or Low-Load Exercise: A Secondary Analysis of an RCT. Physiother Res Int. 2026;31(2):e70197. doi:10.1002/pri.70197
2. Susanne L, Lisbeth C. Wrist Stabilising Exercise Versus Hand Orthotic Intervention for Persons with Hypermobility – A Randomised Clinical Trial. Clin Rehabil. 2025;39(1):47-57. doi:10.1177/02692155241293265