Evaluating the Impact of a Pilates Intervention on Physical Function in Children with Hypermobility Spectrum Disorder: A Study Protocol Using Single-Case Experimental Design

Background: Pilates has been shown to be an effective intervention for adults with musculoskeletal conditions with only a few examples available in the literature for children. As musculoskeletal pain is a major symptom experienced by children with Hypermobility Spectrum Disorder (HSD), they may benefit from practicing Pilates to improve postural alignment, strength and motor control to effectively distribute movement load and decrease adverse load through involved joints. Method: This study aims to evaluate the impact of a Physiotherapy-led Pilates intervention on school aged children with HSD and the benefits of this approach on pain, physical function and quality of life when delivered in a community-based model of care. A single-case experimental design (SCED) that incorporates a multiple baseline design will be used. Children with HSD, aged from 8 to 12 years, will commence concurrently in this study. Participants will undergo multiple assessments through all phases of the study which incorporates an A-B-A withdrawal design. The initial baseline period will be randomised from 5 to 7 weeks duration, then participants will enter the intervention period for 8 weeks followed by a withdrawal period of 5 weeks. The Physiotherapy-led Pilates intervention will consist of individual, 45 minute bi-weekly sessions, performed on both mat and the Pilates Reformer with an additional home program of mat exercises performed weekly. The study hypotheses are that children will show: 1) a decrease in pain;2) an increase in their physical function as measured by muscle strength, postural control, fatigue and physical activity levels;and 3) an improvement in their Health Related Quality of Life in the domains of physical, emotional, social and school functioning. Conclusion: The findings will add specific responsiveness information to the scientific evidence for Physiotherapy-led Pilates for children with HSD.