Quantification of joint laxity.
ABSTRACT We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Carter and Wilkinson (1964), modified by Beighton et al. (1973), in the quantification of joint laxity in a population selected to demonstrate a wide range of joint movement. Both systems correlated well (P less than 0.001) with a 'global index' of joint laxity derived by adding the arcs of movement recorded at most joints in the body by the method of the American Academy of Orthopaedic Surgeons (1965). The Carter and Wilkinson system produced better correlations and is the method of choice for assessing generalized joint laxity.
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ABSTRACT: To test the reproducibility of tests and criteria for generalized joint hypermobility (GJH) and benign joint hypermobility syndrome (BJHS). A standardized protocol for clinical reproducibility studies was followed using a three-phase study (with a training, an overall agreement and a test phase). An overall agreement of at least 0.80 was required to proceed to the test phase. Phases 1, 2 and 3 used 14 patients (with varying degrees of hypermobility), 20 patients (50% cases) and 40 patients (50% cases), respectively. The inclusion criterion for cases was hypermobility (patients with Ehlers-Danlos Syndrome or BJHS) and for controls, non-hypermobility (patients with shoulder and/or back pain); patients were selected from patients' files (phases 1 and 2) or included consecutively from our outpatient clinic (phase 3). The overall agreement in phase 2 was 0.95 for GJH and 0.90 for BJHS. Reproducibility for diagnosing GJH and BJHS in phase 3 showed kappa values of 0.74 and 0.84, respectively. Kappa in the Beighton tests for diagnosing GJH (currently or historically) was generally above 0.80, except for the fifth fingers and elbows (> or = 0.60). In the Brighton tests for diagnosing BJHS, kappa was above 0.73, except for the skin signs (0.63). Lowest kappa was found in the Rotès-Quérol tests, where it was > or = 0.57, except for the right shoulder (0.31). We found a good-to-excellent reproducibility of tests and criteria for GJH and BJHS. Future research on the validity of the tests and criteria for joint hypermobility is urgently needed.Rheumatology (Oxford, England) 12/2007; 46(12):1835-41. · 4.24 Impact Factor
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ABSTRACT: OBJECTIVE: Clinicians may benefit from using a joint mobility index to screen for individuals on the high end of the spectrum of joint laxity (ie, those with generalized joint laxity), which may be associated with musculoskeletal complaints. Reliability of the Beighton and Horan Joint Mobility Index (BHJMI) has not been reported in the literature. Our purpose was to determine intrarater and interrater reliability of (1) composite BHJMI scores (the overall score from 0 to 9), and (2) categorized scores, the BHJMI scores in 3 categories (0 to 2, 3 to 4, and 5 to 9) DESIGN AND SETTING: This was an intrarater and interrater reliability study. Data were collected in an academic physical therapy department and in a high school. SUBJECTS: Forty-two (intrarater) and 36 (interrater) female volunteers, aged 15 to 45 years. MEASUREMENTS: Subjects were screened using the BHJMI. Percentage agreement and the Spearman rho were used to analyze BHJMI composite and category scores. RESULTS: The percentage agreement and the Spearman rho for intrarater and interrater reliability of BHJMI composite scores were 69% and.86 and 51% and.87, respectively. The percentage agreement and the Spearman rho for intrarater and interrater reliability of the category scores were 81% and.81 and 89% and.75, respectively. CONCLUSIONS: Reliability of the BHJMI was good to excellent in screening for generalized joint laxity in females aged 15 to 45 years.Journal of athletic training 01/2004; 38(4):281-285. · 1.68 Impact Factor
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ABSTRACT: General joint hypermobility is estimated to affect about 10% of the population and is a prerequisite of heritable connective tissue disorders where fragile connective tissue is a prominent feature. Pregnancy induced back pain is common whereas about 10% of women still have disabling pain several years after childbirth. The pathogenesis of the pain condition is uncertain, although several risk factors are suggested including general joint hypermobility. In the present study, the possible association of peripheral joint mobility in early pregnancy on the incidence of back pain with onset during pregnancy and persisting after childbirth was explored. A cohort of 200 pregnant women recruited from antenatal health care clinics was assessed by questionnaire and clinical examination, including measurement of passive abduction of the left fourth finger, throughout pregnancy and at 13 weeks postpartum. Comparisons were made between women with and without back pain. Statistical tests used were chi2-test, t-test, Spearman correlation and multiple logistic regression. In the cohort, the mean passive abduction angle of the left fourth finger increased from 40.1[degree sign] in early pregnancy to 41.8[degree sign] at the postpartum appointment. At the postpartum appointment, women in the back pain group had a significantly larger mean passive abduction angle of the left fourth finger of 4.4[degree sign], twice as many previous pregnancies and deliveries, and more than twice as frequent back pain in previous pregnancy, as compared with women with no persistent back pain. A similar pattern was displayed in late pregnancy. In a multiple regression analysis, the passive abduction angle of the left fourth finger in early pregnancy and the number of previous pregnancies were positively, significantly and independently associated to the incidence of back pain in late pregnancy and postpartum. Finger joint laxity as a reflection of constitutional weakness of connective tissue and number of previous pregnancies were associated with the development of back pain induced in pregnancy and persisting after childbirth. These factors may provide a foundation for development of targeted prevention strategies, but this have to be confirmed in future research including measurement of general joint laxity.BMC Pregnancy and Childbirth 02/2014; 14(1):61. · 2.52 Impact Factor