Abstract
BackgroundGeneralized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability. For others GJH is seen as a prerequisite in order to excel in certain sports like dance. However, it remains unclear what the role is of GJH in human performance. Therefore, the purpose of the study was to establish the association between GJH and functional status and to explore the contribution of physical fitness and musculoskeletal complaints to this association.MethodsA total of 72 female participants (mean age (SD; range): 19.6 (2.2; 17-24)) were recruited among students from the Amsterdam School of Health Professions (ASHP) (n = 36) and the Amsterdam School of Arts (ASA), Academy for dance and theater (n = 36) in Amsterdam, The Netherlands. From each participant the following data was collected: Functional status performance (self-reported Physical activity level) and capacity (walking distance and jumping capacity: side hop (SH) and square hop (SQH)), presence of GJH (Beighton score ≥4), muscle strength, musculoskeletal complaints (pain and fatigue) and demographic characteristics (age and BMI).ResultsGJH was negatively associated with all capacity measures of functional status. Subjects with GJH had a reduced walking distance (B(SE):-75.5(10.5), p = <.0001) and jumping capacity (SH: B(SE):-10.10(5.0), p = .048, and SQH: B(SE):-11.2(5.1), p = .024) in comparison to subjects without GJH, when controlling for confounding: age, BMI and musculoskeletal complaints. In participants with GJH, functional status was not associated with performance measures.ConclusionGJH was independently associated with lower walking and jumping capacity, potentially due to the compromised structural integrity of connective tissue. However, pain, fatigue and muscle strength were also important contributors to functional status.
Highlights
Generalized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability
The presence of GJH was significantly higher amongst dancers (66%) in comparison to controls (29%) (X2 = 12.995, p = .001)
Univariate analyses When accounting for differences between dancers and non-dancers (Table 1), dancers showed lower scores on Body Mass Index (BMI) (T = 3.13, p = .002), higher scores on all capacity measures of functional status: Six minute walk test (6MWT) (T = 3.93, p =
Summary
Generalized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability. Connective tissue laxity is a clinical feature of specific pathological entities like Ehlers-Danlos Syndrome, Marfan or Ostegenesis Imperfecta [3] These hereditary diseases of connective tissue (HDCT) are rare and can have serious consequences in terms of disability and in some cases may even result in death. In recent years the genetic origin of collagen diseases has been explored [4,5,6,7], whereas a subgroup of connective tissue disorders was identified This subgroup of connective tissue disorders shares the typical, less severe, clinical presentation, but lacks biological markers [8]. These disorders are often referred to as Hypermobility Syndrome (HMS) or Ehlers-Danlos Syndrome (hypermobile type) [9]. The exact prevalence is unknown, and estimates do vary [10]
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