Better Mobility Lab

Dr. Manocha is a physiatrist (specialist doctor in Physical Medicine & Rehabilitation). Dr. Manocha’s role is to assist in the physical rehabilitation of the musculoskeletal (bone and joint) consequences of connective tissue disorders, particularly with regards to exercises, bracing, adaptive equipment, preparing for and recovering from surgery, preparing for pregnancy and the postpartum period, adapting hobbies/work/family life, and educating your other healthcare providers.

For more information on what a physiatrist is, please click here.

The following educational websites are provided for general guidance. We do not take responsible for site content. Site content does not constitute medical advice. Please speak to your own healthcare providers for further guidance.

• Hypermobility Spectrum Disorders & the Ehlers-Danlos Syndromes
  • Foundations & Societies (For Patients):
    • EDS Society
      • https://www.ehlers-danlos.com/
    • Hypermobility Syndromes Association
      • https://www.hypermobility.org/
    • The ILC Foundation
      • https://www.theilcfoundation.org/
    • Ehlers Danlos Society UK
      • https://www.ehlers-danlos.org/
  • Peer Support (For Patients):
    • Ehlers Danlos Syndrome Canada
      • https://www.facebook.com/edscanada/
    • EDS & Patient Engagement in Canadian Research (EDS Canada)
      • https://www.facebook.com/groups/115737332411227/
    • The Ehlers-Danlos Syndrome Society
      • https://www.ehlers-danlos.com/community-resources/
    • Loose Connections Magazine
      • https://www.ehlers-danlos.com/loose-connections-emagazine/
    • Dysautonomia Support Network
      • https://www.dysautonomiasupport.org/
  • Books
    • Bending Without Breaking - Isobel Knight
    • Disjointed: Navigating the Diagnosis and Management of Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders - Paldeep Atwal, Myles Koby, Jill Schofield
    • Joint Hypermobility Handbook: A Guide for the Issues & Management of Ehlers-Danlos Syndrome Hypermobility Type and the Hypermobility Syndrome - Brad T. Tinkle
  • Diet & EDS/HSD
    • https://tinyurl.com/hacmdeds
  • Mast Cell Dysfunction
    • For Patients:
      • The Mastocytosis Society of Canada
        • https://www.mastocytosis.ca/en/
    • For Healthcare Providers/Researchers:
      • Brock I et al. Mast cell activation disease and immunoglobulin deficiency in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorder. Am J Med Genet C Semin Med Genet. 2021 Dec;187(4):473-481.
  • For Healthcare Providers/Researchers:
    • Overviews of Classifications and Presentations (For Healthcare Providers & Researchers):
      • Malfait F et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):8-26.
      • Brady AF et al. The Ehlers-Danlos syndromes, rare types. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):70-115.
      • Castori M et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):148-157.
    • Respiratory Complications
      • Bascom R et al. Respiratory manifestations in the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2021 Dec;187(4):533-548.
    • Classical EDS (cEDS)
      • Bowen JM et al. Ehlers-Danlos syndrome, classical type. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):27-39.
    • Hypermobile EDS (hEDS)
      • Castori M et al. Natural history and manifestations of the hypermobility type Ehlers-Danlos syndrome: a pilot study on 21 patients. Am J Med Genet A. 2010 Mar;152A(3):556-64.
      • How to diagnose hEDS
    • Hypermobility Spectrum Disorders/Hypermobile EDS
      • Exercise interventions
        • Buryk-Iggers S et al. Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl. 2022 Mar 4;4(2):100189. doi: 10.1016/j.arrct.2022.100189.
        • Smith TO et al. (2013). Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials. Disability and Rehabilitation, 36(10), 797–803. 
        • Zabriskie HA. Rationale and Feasibility of Resistance Training in hEDS/HSD: A Narrative Review. J Funct Morphol Kinesiol. 2022 Aug 20;7(3):61. doi: 10.3390/jfmk7030061.
• Vascular EDS (vEDS)
  • Byers PH et al. Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):40-47.
• Marfan, Loeys-Dietz, Familial Aortic Aneurysm, and Stickler Syndromes
  • Clinical Management Videos & Tools - GenTAC Alliance
  • Loeys-Dietz Syndromes
    • Loeys-Dietz Syndrome Foundation Canada
      • http://www.loeysdietzcanada.org/
    • For Healthcare Providers:
      • General:
        • MacCarrick G et al. Loeys-Dietz syndrome: a primer for diagnosis and management. Genet Med. 2014 Aug;16(8):576-87.
        • Williams JA et al. Early surgical experience with Loeys-Dietz: a new syndrome of aggressive thoracic aortic aneurysm disease. Ann Thorac Surg. 2007 Feb;83(2):S757-63; discussion S785-90.
      • Bone Health:
        • Guerrerio AL et al. Predictors of low bone density and fracture risk in Loeys-Dietz syndrome. Genet Med. 2022 Feb;24(2):419-429.
  • Marfan Syndrome
    • The Marfan Foundation
      • https://www.marfan.org/
    • For Healthcare Providers:
      • How to diagnose Marfan Syndrome
      • Bitterman AD et al. Marfan Syndrome: A Clinical Update. J Am Acad Orthop Surg. 2017 Sep;25(9):603-609. 
      • Dean JC. Marfan syndrome: clinical diagnosis and management. Eur J Hum Genet. 2007 Jul;15(7):724-33.
      • Cardiovascular complications:
        • Roman MJ et al. Prognostic significance of the pattern of aortic root dilation in the Marfan syndrome. J Am Coll Cardiol. 1993 Nov 1;22(5):1470-6.
  • For Healthcare Providers & Researchers:
    • General Genetics & Presentation:
      • Verstraeten A et al. Marfan Syndrome and Related Disorders: 25 Years of Gene Discovery. Hum Mutat. 2016 Jun;37(6):524-31.
• General
  • Videos for Patients:
    • See resource websites above
    • Hope for Hypermobility 2024 
      • http://www.youtube.com/@BetterMobilityLab
    • Getting stuck in the negatives (and how to get unstuck) - Alison Ledgerwood
      • https://www.youtube.com/watch?v=7XFLTDQ4JMk
    • How to have effective doctor appointments - Shani Weber
      • https://www.youtube.com/watch?v=iVZGy9Y3M2k&list=PLJ8LTDV_7QkvNCk1sYXY8IqzajPbtpPYr&index=40&t=27s
  • For Healthcare Providers & Researchers:
    • Clinical manifestations:
      • Meester JAN et al. Differences in manifestations of Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome. Ann Cardiothorac Surg. 2017 Nov;6(6):582-594.
    • Bone health:
      • Charoenngam N et al. Bone Fragility in Hereditary Connective Tissue Disorders: A Systematic Review and Meta-Analysis. Endocr Pract. 2023 Jul;29(7):589-600.