Abstract

The primary aim of the study was to explore the prevalence of generalized joint hypermobility (GJH) and generalized hypermobility spectrum disorder (gHSD) using the new classification system in a community paediatric physiotherapy service in Ireland. The second aim was to explore the relationship between GJH, gHSD and physical activity level, while considering the association of probable developmental coordination disorder (pDCD). A case-controlled cross-sectional study of children aged 6-12 years, recruited from the community paediatric physiotherapy department (n = 32) and a local school (n = 41), was carried out. A Beighton score of ≥6/9 distinguished GJH. The new framework for hypermobility spectrum disorder (HSD) was used. Self-reported physical activity level was measured using the Physical Activity Questionnaire-Older Children. A parent-reported validated questionnaire screened for pDCD. The prevalence of GJH was 21.9% of children attending physiotherapy. One child in the physiotherapy group was identified as having gHSD, with a prevalence of 3.1%. There was no significant difference in physical activity level between children with and without GJH attending physiotherapy (independent samples t-test, p = 0.28). Probable developmental coordination disorder (pDCD) was observed in 71.9% of children attending physiotherapy. There was no significant difference in the number of children with pDCD in those with and without GJH (Fisher's exact test, p = 0.370). This study was the first to explore the prevalence of GJH and gHSD in the paediatric physiotherapy population in Ireland. The presence of GJH did not affect self-reported physical activity level or motor coordination in children attending physiotherapy.

Highlights

  • Joint hypermobility (JH) is defined as an excessive range of motion of a joint, taking into consideration the patient's gender, age and ethnic background (Grahame, 2009)

  • The present study demonstrated a prevalence of Generalized joint hypermobility (GJH) of 21.9% in children attending a paediatric physiotherapy department and 17.1% in local schoolchildren in Ireland

  • There was no significant difference in physical activity level in children with or without GJH in either the school group or the physiotherapy group

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Summary

Introduction

Joint hypermobility (JH) is defined as an excessive range of motion of a joint, taking into consideration the patient's gender, age and ethnic background (Grahame, 2009). In 2017, as a result of an international expert consensus group, a new framework and nomenclature for the hypermobility spectrum in children and adults was proposed In this new framework, when JH occurs together with symptoms (usually musculoskeletal), and when hypermobile Ehlers– Danlos syndrome (hED) or other Ehlers–Danlos syndromes have been excluded, it is referred to as hypermobility spectrum disorder (HSD) (Castori et al, 2017). This new classification for HSD, which is internationally acknowledged, describes four different phenotypes of HSD: localized HSD, historical HSD, peripheral HSD and generalized HSD (gHSD)

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