Inter- and intra-rater reliability of the Beighton Score compared to the Contompasis Score to assess generalised joint hypermobility

Abstract

Background: Generalised joint hypermobility (GJH) is a common connective tissue disorder associated with a range of musculoskeletal complaints. An effective screening tool to assess GJH may influence our understanding and choice of management. Diagnosis is clinical, using tools such as the Beighton Hypermobility Score and the Contompasis Scoring System. The comparable reliability of these tools has not been previously reported. The aim of the present study was to compare the intra- and inter-rater reliability of the Beighton Score to the Contompasis Score to assess GJH. Methods: This was a randomised observational study assessing 36 pain-free participants: 27 females and nine males, with a mean age of 22.7 years ± 3.71 (range 18 to 32 years). Participants were assessed by two researchers over two sessions to allow for intra- and inter-rater analysis. Intraclass correlation coefficient (ICC) and weighted Kappa statistics were used to calculate the level of agreement. Results: The intra- (ICC=0.71–0.82) and inter-rater (ICC=0.72–0.80) reliability of the Beighton Score is substantial to almost perfect. The Contompasis Score displayed substantial to almost perfect intra-rater (ICC=0.73–0.82) reliability and moderate to substantial inter-rater (ICC=0.58–0.62) reliability. Conclusions: It is hypothesised that in clinical practice the Beighton Score is more appropriate due to greater inter-rater reliability, whereas in a research setting with experienced practitioners, the Contompasis Score would be more appropriate, due to almost perfect intra-rater reliability. Implications: The present study provides an indication of the measurement capabilities of the Beighton and Contompasis Scores, as well as providing a platform for further research.