Assessment of lower limbs in people with Generalized Joint Hypermobility (GJH) - preliminary report

Introduction: Generalized Joint Hypermobility (GJH) is defined as an increased range of motion in joints. There is no causal treatment of GJH, therefore the therapy should be based on the individual needs of patients after the comprehensive diagnostic of body posture. The occurrence of deformities of lower limbs in people with GJH should be an indication for the therapy. The aim of this study was the assessment of the impact of Generalized Joint Hypermobility on the lower limbs position. Materials and methods: The research was conducted on 30 children, aged 7–13 (10.1 ± 1.7), 51 adults aged 20–29 (23.2 ± 1.6). The study included the assessment of external and internal rotation of hips, tibial torsion, axis of lower limbs, longitudinal and transverse arch of the feet. Females with ≥5 and males with ≥4 scores in the Beighton test were included in the GJH groups. Results: Both children and adults with GJH presents higher internal rotation of hips in comparison to the control group (p = 0.03 for right and p = 0.00 for left side, and p = 0.00 for right and p = 0.00 for left side, for children and adults, respectively). Children with GJH obtained higher values of the Clarke angle for the right foot compared to the control group (p = 0.00). Conclusions: Regardless of age, subjects with Generalized Joint Hypermobility are characterized by higher internal rotation of the hip compared to healthy controls. Children with GJH present a higher longitudinal arch of the feet compared to peers, but the results fall within the normative ranges.

[1]  D. Czaprowski,et al.  Muscle strength, muscle power and body composition in college-aged young women and men with Generalized Joint Hypermobility , 2020, PloS one.

[2]  P. Newcombe,et al.  Generalized joint hypermobility in siblings with anterior cruciate ligament injuries and matched unrelated healthy siblings. , 2020, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[3]  K. Pawłowska,et al.  Feet deformities in patients with hip osteoarthritis , 2019, Medical Research Journal.

[4]  K. Finn,et al.  COMPARISON OF HIP INTERNAL AND EXTERNAL ROTATION BETWEEN INTERCOLLEGIATE DISTANCE RUNNERS AND NON-RUNNING COLLEGE STUDENTS. , 2018, International journal of sports physical therapy.

[5]  C. Kawamura,et al.  Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy , 2018, Einstein.

[6]  Luke S Hopper,et al.  Identifying lower limb specific and generalised joint hypermobility in adults: validation of the Lower Limb Assessment Score , 2017, BMC Musculoskeletal Disorders.

[7]  Stephan Schulze,et al.  Inter- and intrarater reliability of goniometry and hand held dynamometry for patients with subacromial impingement syndrome , 2017, Journal of exercise rehabilitation.

[8]  Y. Yoon,et al.  A New Instrument for Measuring Tibial Torsion in Pediatric Patients , 2017, Annals of rehabilitation medicine.

[9]  S. Pita-Fernández,et al.  Variability between Clarke's angle and Chippaux-Smirak index for the diagnosis of flat feet , 2017, Colombia medica.

[10]  R. Engelbert,et al.  Measurement properties of clinical assessment methods for classifying generalized joint hypermobility—A systematic review , 2017, American journal of medical genetics. Part C, Seminars in medical genetics.

[11]  R. Engelbert,et al.  The evidence‐based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome , 2017, American journal of medical genetics. Part C, Seminars in medical genetics.

[12]  J. Russell,et al.  Kinematic analysis of hip and knee rotation and other contributors to ballet turnout , 2017, Journal of sports sciences.

[13]  D. Czaprowski,et al.  The Influence of the “Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility , 2017, BioMed research international.

[14]  Kurt R. Neelly,et al.  The Reliability of Smartphone and Goniometric Measurements of Hip Range of Motion , 2016 .

[15]  Núria Massó-Ortigosa,et al.  Reliability and Validity of the Footprint Assessment Method Using Photoshop CS5 Software in Young People with Down Syndrome. , 2016, Journal of the American Podiatric Medical Association.

[16]  J. Macdermid,et al.  Muscle strength differences in healthy young adults with and without generalized joint hypermobility: a cross-sectional study , 2016, BMC Sports Science, Medicine and Rehabilitation.

[17]  L. Russek,et al.  Prevalence, injury rate and, symptom frequency in generalized joint laxity and joint hypermobility syndrome in a “healthy” college population , 2016, Clinical Rheumatology.

[18]  Manuela Galli,et al.  The effects of neuromuscular taping on gait walking strategy in a patient with joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type , 2015, Therapeutic advances in musculoskeletal disease.

[19]  S. Pita-Fernández,et al.  Validity of Footprint Analysis to Determine Flatfoot Using Clinical Diagnosis as the Gold Standard in a Random Sample Aged 40 Years and Older , 2014, Journal of epidemiology.

[20]  B. Najafi,et al.  Assessing plantar pressure distribution in children with flatfoot arch: application of the Clarke angle. , 2014, Journal of the American Podiatric Medical Association.

[21]  B. Jensen,et al.  Gait pattern in 9-11-year-old children with generalized joint hypermobility compared with controls; a cross-sectional study , 2013, BMC Musculoskeletal Disorders.

[22]  Tomasz Kotwicki,et al.  Assessment of joint laxity in children and adolescents: a review of methods. , 2012, Ortopedia, traumatologia, rehabilitacja.

[23]  Cac Villamin,et al.  Tibial torsion among filipinos: a cadaveric study. , 2012, Malaysian orthopaedic journal.

[24]  K. Baldwin,et al.  Hip Range of Motion in Children: What Is the Norm? , 2012, Journal of pediatric orthopedics.

[25]  Keith Rome,et al.  The foot posture index, ankle lunge test, Beighton scale and the lower limb assessment score in healthy children: a reliability study , 2012, Journal of Foot and Ankle Research.

[26]  Susan L. Henry,et al.  Managing Intoeing in Children , 2011 .

[27]  D. Czaprowski,et al.  Joint hypermobility in children with idiopathic scoliosis: SOSORT award 2011 winner , 2011, Scoliosis.

[28]  Chris Riddoch,et al.  Epidemiology of Generalized Joint Laxity (Hypermobility) in Fourteen-Year-Old Children From the UK: A Population-Based Evaluation , 2011, Arthritis and rheumatism.

[29]  B. Juul-Kristensen,et al.  Motor Competence and Physical Activity in 8-Year-Old School Children With Generalized Joint Hypermobility , 2009, Pediatrics.

[30]  W. Reinus,et al.  Reliability and Validity of Goniometric Turnout Measurements Compared with MRI and Retro-Reflective Markers , 2008, Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science.

[31]  Tomasz Kotwicki,et al.  Trunk rotation and hip joint range of rotation in adolescent girls with idiopathic scoliosis: does the "dinner plate" turn asymmetrically ? , 2008, Scoliosis.

[32]  Stacie Bertram Hypermobility Syndrome: Recognition and Management for Physiotherapists. , 2005 .

[33]  J. Hertel,et al.  Lower extremity malalignments and anterior cruciate ligament injury history. , 2004, Journal of sports science & medicine.

[34]  Pamela Sass,et al.  Lower extremity abnormalities in children. , 2003, American family physician.

[35]  L. Karol Rotational deformities in the lower extremities , 1997, Current opinion in pediatrics.

[36]  I. Kotela,et al.  THE ANALYSIS OF FEET CONSTRUCTION VERSUS BMI IN 8-YEAR-OLD BOYS , 2017 .

[37]  M. Pasek,et al.  Prevalence of generalised joint hypermobility in school-aged children from east-central European region. , 2016, Folia morphologica.

[38]  T. Takken,et al.  Motor Performance in Children with Generalized Hypermobility: The Influence of Muscle Strength and Exercise Capacity , 2009, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[39]  P. Helders,et al.  The Relationship Between Generalized Joint Hypermobility and Motor Development , 2005, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[40]  T. B. Edwards,et al.  Reliability of the quadriceps angle measurement. , 2001, The American journal of knee surgery.