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Jeong HJ, Engel JM, Muriello M, Basel D, Slavens BA. The association of pain with gait spatiotemporal parameters in children with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder. Gait Posture 2024; 109:271-276. [PMID: 38368648 DOI: 10.1016/j.gaitpost.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/22/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Children with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/hEDS) have a high prevalence of chronic pain, which may influence gait dynamics. However, little is known about pain outcomes and their association with gait spatiotemporal parameters in children with HSD/hEDS. RESEARCH QUESTION Does pain correlate with gait spatiotemporal parameters in children with HSD/hEDS? METHODS Eighteen children with HSD/hEDS and eighteen typically developing (TD) children participated in the study. The current level of pain (0-10 on the numeric rating scale), modified Brief Pain Inventory, and Pain Catastrophizing Scale-Child version were implemented to assess pain in children with HSD/hEDS. All children completed a gait analysis at a self-selected speed. Mean and variability (measured using the coefficient of variation) of gait spatiotemporal parameters were analyzed. Gait parameters included stride length, stride time, gait speed, percent stance time, and step width. A Mann-Whitney U-test was used to compare the gait parameters between children with HSD/hEDS and TD children. Spearman correlations were used to examine the relationships between pain and gait spatiotemporal parameters in children with HSD/hEDS. RESULTS Children with HSD/hEDS had a longer percent stance time compared to TD children (p = 0.03). Lower pain interference in relationships with other people was significantly associated with faster gait speeds (ρ = -0.55, p = 0.03). Children with HSD/hEDS also had greater pain interference during mobility (ρ = 0.5, p = 0.05) and going to school (ρ = 0.65, p = 0.01), which were significantly correlated with greater stride length variability. Greater pain interference during enjoyment of life was significantly associated with greater percent stance time variability (ρ = 0.5, p = 0.05). Greater pain catastrophizing was correlated with decreased step width variability in children with HSD/hEDS (ρ = -0.49, p = 0.05). SIGNIFICANCE Pain interference and catastrophe were significantly associated with gait spatiotemporal variability. Our findings suggest that assessing pain-associated gait alterations may help understand the clinical features and gait kinematics of children with HSD/hEDS.
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Affiliation(s)
- Hyo-Jung Jeong
- Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA; Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
| | - Joyce M Engel
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Michael Muriello
- Division of Genetics, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Donald Basel
- Division of Genetics, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brooke A Slavens
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Department of Mechanical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Department of Biomedical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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de Koning LE, Scheper MC, Ploeger HE, Warnink-Kavelaars J, Oosterlaan J, Bus SA, Engelbert RHH. An exploratory study of clinical characteristics and gait features of adolescents with hypermobility disorders. Gait Posture 2023; 100:222-229. [PMID: 36638668 DOI: 10.1016/j.gaitpost.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND In adolescents with non-pathological and pathological joint hypermobility, gait deviations have been associated with pain and fatigue. It remains unclear what distinguishes the non-pathological form of joint hypermobility (JH) from pathological forms (i.e. hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD). Our objective was to identify discriminative clinical characteristics and biomechanical gait features between adolescents with hEDS/HSD, JH, and healthy controls (HC). METHODS Thirty-two adolescents were classified into three subgroups (hEDS/HSD=12, JH=5, HC=15). Clinical characteristics (e.g. pain intensity and surface, fatigue, functional disability) were inventoried. The gait pattern was assessed using a three-dimensional, eight-camera VICON MX1.3 motion capture system, operating at a sample rate of 100 Hz (VICON, Oxford, UK). Spatiotemporal parameters, joint angles (sagittal plane), joint work, joint impulse, ground reaction force and gait variability expressed as percentage using Principal Component Analysis (PCA) were assessed and analysed using multivariate analysis. Multivariate analysis data is expressed in mean differences(MD), standard error(SE) and P-values. RESULTS The hEDS/HSD-group had significantly higher fatigue score (+51.5 points, p = <0.001) and functional disability (+1.6, p < .001) than the HC-group. Pain intensity was significantly higher in the hEDS/HSD-group than the other subgroups (JH; +37 mm p = .004, HC; +38 mm, p = .001). The hEDS/HSD-group showed significantly more gait variability (JH; +7.2(2.0)% p = .003, HC; + 7.8(1.4)%, p = <0.001) and lower joint work (JH; -0.07(0.03)J/kg, p = .007, HC; - 0.06(0.03)J/kg, p = .013) than the other subgroups. The JH-group showed significantly increased ankle dorsiflexion during terminal stance (+5.0(1.5)degree, p = .001) compared to hEDS/HSD-group and knee flexion during loading response compared to HC-group (+5.7(1.8) degree, p = .011). SIGNIFICANCE A distinctive difference in gait pattern between adolescents with non-pathological and pathological joint hypermobility is found in gait variability, rather than in the biomechanical features of gait. This suggests that a specific gait variability metric is more appropriate than biomechanical individual joint patterns for assessing gait in adolescents with hEDS/HSD.
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Affiliation(s)
- Lisanne E de Koning
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Mark C Scheper
- Rotterdam University of Applied Sciences, Institute for Health, (pediatric) Physical Therapy, Rochussenstraat 198, 3015 Rotterdam, the Netherlands; Research Center Innovations In Care, Transitions in Care / Data-supported Healthcare, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 Rotterdam, the Netherlands; Department of Health Professions, Faculty of Medicine and Health, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia.
| | - Hilde E Ploeger
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
| | - Jessica Warnink-Kavelaars
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction & Development, Amsterdam, the Netherlands.
| | - Sicco A Bus
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.
| | - Raoul H H Engelbert
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands.
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Chen H, Zeng X, Xie Z, Ma L, Zhong G, Li L, Huang W, Zhang Y. Kinematic alterations of the ankle in subjects with generalized joint hypermobility compared with the controls: A cross-sectional study. J Orthop Surg (Hong Kong) 2022; 30:10225536221125951. [PMID: 36113013 DOI: 10.1177/10225536221125951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Generalized joint hypermobility (GJH) is a hereditary connective tissue disease in which the range of motion (ROM) of multiple joints exceeds the normal range, and the ROM varies with age, gender, and ethnicity. At present, the six-degree-of-freedom (6-DOF) of ankle kinematics among people with GJH have not been studied. To investigate the kinematic characteristics in the ankle during treadmill gait of university students with generalized joint hypermobility compared to normal participants. We hypothesized that compared to the participants in the control group, those with GJH would exhibit kinematic characteristics of poorer active motion stability in the ankle during treadmill gait. METHODS Healthy university student volunteers aged 18-24 (excluding those with a history of ankle trauma, etc.) were recruited and divided into a control group (50 volunteers) and a GJH group (Beighton score ≥4, 50 volunteers). Data of the 6-DOF kinematics of ankle was collected using a 3D gait analysis system. Variables were evaluated using independent t-tests and Wilcoxon signed-rank tests. RESULTS In the proximal/distal parameter, proximal displacement was significantly increased in the GJH group compared with the control group during 4-9% and 96-97% of the gait phase (loading response and terminal swing phase), with an increase of (0.1-0.2 cm, p < .05). Regarding the proximal/distal, internal/external, plantarflexion/dorsiflexion, and anterior/posterior parameters, the participants with GJH exhibited greater ROM than those in the control group throughout the gait cycle (0.24 ± 0.22 cm vs. 0.19 ± 0.15 cm, p = 0.047, 5.56 ± 2.90° vs. 4.48 ± 3.30°, p = .020, 23.05 ± 5.75° vs. 20.36 ± 4.91°, p < .001, 0.65 ± 0.30 cm vs. 0.55 ± 0.27 cm, p = .018). However, ROM of inversion/eversion translation was found to be decreased in the GJH group compared to the control group (8.92 ± 1.59° vs. 9.47 ± 1.37°, p = .009). In addition, there was no statistical difference between the GJH group and the control group in ROM of medial/lateral translation (0.05 ± 0.06 cm vs. 0.04 ± 0.05 cm, p = .131). CONCLUSION Our results confirm that our hypothesis is not valid. Although there were a few differences in each gait parameter of the ankle between the GJH group and the control group, the difference was not significant. These results indicate that the presence of GJH has less effect on ankle kinematics and enhance our knowledge of the relationship between GJH and 6-DOF of ankle kinematics.
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Affiliation(s)
- Haobin Chen
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xiaolong Zeng
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhenyan Xie
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Limin Ma
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guoqing Zhong
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Liping Li
- Shantou University Medical College, Shantou, China
| | - Wenhan Huang
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu Zhang
- Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Masterclass: Hypermobility and hypermobility related disorders. Musculoskelet Sci Pract 2022; 57:102465. [PMID: 34808594 DOI: 10.1016/j.msksp.2021.102465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 08/27/2021] [Accepted: 10/10/2021] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Hypermobile joints display a range of movement that is considered excessive, taking into consideration the age, gender and ethnic background of the individual. Joint hypermobility may present in a single joint, a few joints or in multiple joints and may be congenital or acquired with training, disease or injury. Hypermobile joints may be asymptomatic or may be associated with pain, fatigue, multisystemic complaints and significant disability. Furthermore, joint hypermobility may be a sign of an underlying hereditary disorder of connective tissue. PURPOSE This masterclass aims to provides a state-of-the-art review of the aetiology, epidemiology, clinical presentation, assessment and management of joint hypermobility and hypermobility related disorders using an evidence based and biopsychosocial approach. The new framework for classifying the spectrum of joint hypermobility disorders along with new diagnostic criteria for the hypermobile Ehlers Danlos syndrome, published by an international consortium of clinical experts and researchers in 2017 is integrated into the paper. IMPLICATIONS FOR PRACTICE People with joint hypermobility related disorders present to healthcare professionals with a wide range of symptoms which extend beyond the musculoskeletal system. Early recognition and treatment are key to effective management. A biopsychosocial and patient empowerment approach to functional restoration is recommended.
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Hwang M, Flanagan A, Graf A, Kruger KM, Scullion N, Tayne S, Altiok H. Gait Characteristics in Youth With Transverse Myelitis. Top Spinal Cord Inj Rehabil 2021; 27:38-48. [PMID: 34456545 DOI: 10.46292/sci20-00048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Transverse myelitis (TM) in childhood is a rare disorder characterized by the presence of spinal cord inflammation. Gait difficulty in children with TM is common; however, there is a paucity of literature regarding quantitative assessment of gait in children and adolescents with TM. Objectives To characterize gait patterns in a cohort of ambulatory children with TM and age-matched, typically developing peers in order to better understand the functional mobility of patients diagnosed with childhood TM. Methods This was a retrospective study of 26 ambulatory pediatric patients with a confirmed diagnosis of TM who had undergone three-dimensional, instrumented gait analysis (3D-IGA) at 3 years of age or older. A group of 38 typically developing children served as a control group. Results Gait in children with TM was characterized by moderate kinematic deviations as measured by the Gait Deviation Index (GDI) and a crouched gait pattern (p < .001), increased anterior pelvic tilt (p < .001), decreased motion at the knees (p < .001), and a wider base of support (foot progression angle, p < .001). The TM group had a slower walking speed (p < .001), shorter strides (p < .001), and an increased stance phase compared to controls. Conclusion Our study results showed moderate kinematic deviations quantified by the GDI. Overall, the gait pattern in the TM population tested had greater hip and knee flexion with wider foot progression angle. Identification of gait characteristics in children with TM is the first step in predicting changes in gait pattern as they mature over time, which may ultimately allow for targeted intervention to maintain their ambulatory function.
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Affiliation(s)
- Miriam Hwang
- Shriners Hospitals for Children, Chicago, Illinois
| | - Ann Flanagan
- Shriners Hospitals for Children, Chicago, Illinois
| | - Adam Graf
- Shriners Hospitals for Children, Chicago, Illinois
| | - Karen M Kruger
- Shriners Hospitals for Children, Chicago, Illinois.,Marquette University, Milwaukee, Wisconsin
| | | | | | - Haluk Altiok
- Shriners Hospitals for Children, Chicago, Illinois
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Bates AV, McGregor AH, Alexander CM. Comparing sagittal plane kinematics and kinetics of gait and stair climbing between hypermobile and non-hypermobile people; a cross-sectional study. BMC Musculoskelet Disord 2021; 22:712. [PMID: 34412618 PMCID: PMC8377885 DOI: 10.1186/s12891-021-04549-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/12/2021] [Indexed: 12/03/2022] Open
Abstract
Background Joint Hypermobility Syndrome (JHS) presents with a range of symptoms including widespread joint hypermobility and chronic arthralgia. The study objective was to investigate whether impairments in JHS are due to hypermobility or another factor of JHS by identifying impairments in gait and stair-climbing tasks; an activity that is demanding and so may better show differences between the cohorts. Methods Sixty-eight adults participated; 23 JHS, 23 Generalised Joint Hypermobility (GJH), and 22 Normal Flexibility (NF). Inclusion criteria for JHS participants were a positive classification using the Brighton Criteria, for GJH a Beighton Score ≥ 4, and for NF a Beighton Score < 4 with no hypermobile knees. Participants were recorded with a 10-camera Vicon system whilst they performed gait and stair-climbing. Temporal-spatial, and sagittal plane kinematic and kinetic outcome measures were calculated and input to statistical analyses by statistical parametric mapping (SPM). Results During the gait activity JHS had significantly greater stride time and significantly lower velocity than NF, and significantly greater stride time, lower velocity, and lower stride length than GJH. SPM analysis showed no significant differences between groups in gait kinematics. There were significant differences between groups for gait moments and powers; people with JHS tended to have lower moments and generate less power at the ankle, and favour power generation at the knee. A similar strategy was present in stair ascent. During stair descent people with JHS showed significantly more hip flexion than people with NF. Conclusions As there was only one significant difference between GJH and NF we conclude that impairments cannot be attributed to hypermobility alone, but rather other factor(s) of JHS. The results show that both gait and stair-climbing is impaired in JHS. Stair-climbing results indicate that JHS are using a knee-strategy and avoiding use of the ankle, which may be a factor for clinicians to consider during treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04549-2.
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Affiliation(s)
- Alexander Vernon Bates
- Department of Surgery and Cancer, Imperial College London, London, UK. .,Department of Therapies, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK.
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline M Alexander
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Physiotherapy, Imperial College Healthcare NHS Trust, London, UK
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Dierick F, Schreiber C, Lavallée P, Buisseret F. Asymptomatic Genu Recurvatum reshapes lower limb sagittal joint and elevation angles during gait at different speeds. Knee 2021; 29:457-468. [PMID: 33743261 DOI: 10.1016/j.knee.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Kinematic characteristics of walking with an asymptomatic genu recurvatum are currently unknown. The objective of this study is to characterize the lower limb sagittal joint and elevation angles during walking in participants with asymptomatic genu recurvatum and compare it with control participants without knee deformation at different speeds. METHODS The spatio-temporal parameters and kinematics of the lower limb were recorded using an optoelectronic motion capture system in 26 participants (n = 13 with genu recurvatum and n = 13 controls). The participants walked on an instrumented treadmill during five minutes at three different speeds: slow, medium and fast. RESULTS Participants with genu recurvatum showed several significant differences with controls: a narrower step width, a greater maximum hip joint extension angle, a greater knee joint extension angle at mid stance, a lower maximum knee joint flexion angle during the swing phase, and a greater ankle joint extension angle at the end of the gait cycle. Participants with genu recurvatum had a greater minimum thigh elevation angle, a greater maximum foot elevation angle, and a change in the orientation of the covariance plane. Walking speed had a significant effect on nearly all lower limb joint and elevation angles, and covariance plane parameters. CONCLUSION Our findings show that genu recurvatum reshapes lower limb sagittal joint and elevation angles during walking at different speeds but preserves the covariation of elevation angles along a plane during both stance and swing phases and the rotation of this plane with increasing speed.
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Affiliation(s)
- Frédéric Dierick
- Centre National de Rééducation Fonctionnelle et de Réadaptation - Rehazenter, Laboratoire d'Analyse du Mouvement et de la Posture (LAMP), Luxembourg, Luxembourg; CeREF, Haute Ecole Louvain en Hainaut, Mons, Belgium; Faculté des Sciences de la Motricité, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
| | - Céline Schreiber
- Centre National de Rééducation Fonctionnelle et de Réadaptation - Rehazenter, Laboratoire d'Analyse du Mouvement et de la Posture (LAMP), Luxembourg, Luxembourg
| | - Pauline Lavallée
- Laboratoire Forme et Fonctionnement Humain, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Fabien Buisseret
- CeREF, Haute Ecole Louvain en Hainaut, Mons, Belgium; Laboratoire Forme et Fonctionnement Humain, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium; Service de Physique Nucléaire et Subnucléaire, Université de Mons, UMONS Research Institute for Complex Systems, Mons, Belgium
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Vermeulen S, De Mits S, De Ridder R, Calders P, De Schepper J, Malfait F, Rombaut L. Altered multi‐segment ankle and foot kinematics during gait in patients with Hypermobile Ehlers‐Danlos Syndrome/Hypermobility spectrum disorder. A case‐control study. Arthritis Care Res (Hoboken) 2020; 74:841-848. [DOI: 10.1002/acr.24526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/21/2020] [Accepted: 12/01/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Stefan Vermeulen
- Department of Rehabilitation Sciences Ghent University Ghent Belgium
| | - Sophie De Mits
- Department of Rheumatology Ghent University Hospital Ghent Belgium
- Department of Podiatry Artevelde University of Applied Sciences Ghent Belgium
| | - Roel De Ridder
- Department of Rehabilitation Sciences Ghent University Ghent Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences Ghent University Ghent Belgium
| | - Joris De Schepper
- Department of Podiatry Artevelde University of Applied Sciences Ghent Belgium
| | | | - Lies Rombaut
- Center for Medical Genetics Ghent University Hospital Ghent Belgium
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Sirajudeen MS, Waly M, Alqahtani M, Alzhrani M, Aldhafiri F, Muthusamy H, Unnikrishnan R, Saibannavar R, Alrubaia W, Nambi G. Generalized joint hypermobility among school-aged children in Majmaah region, Saudi Arabia. PeerJ 2020; 8:e9682. [PMID: 32864212 PMCID: PMC7427539 DOI: 10.7717/peerj.9682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022] Open
Abstract
Generalized joint hypermobility (GJH) is common among schoolchildren and usually benign. However, it may progressively lead to joint pain and developmental delay. Identifying GJH in school-aged children would facilitate the monitoring of early changes and planning for early rehabilitative intervention. Epidemiological studies addressing the prevalence of GJH among children in the Gulf region and Arab ethnicity are lacking. Hence, we aimed to determine the prevalence, pattern, and factors associated with GJH among school-aged children in the Majmaah region, Saudi Arabia. Male and female school-aged children 8–14 years of age from the Majmaah region of Saudi Arabia participated in this cross-sectional study. Beighton score was used to assess GJH. Personal characteristics such as age, height, weight, body mass index, and handedness were also collected. Descriptive statistics were obtained for personal characteristics, the point prevalence of hypermobility, frequency of Beighton score distribution, and prevalence of GJH. The associations between specific factors and the presence of GJH were analyzed using chi-square and Mann-whitney tests. Using the Beighton score cutoff ≥ 4 and ≥ 6, 15.2% and 7.6% of the school children in our study were diagnosed with GJH respectively. The prevalence of GJH was higher among females (16.8%) than among males (13.4%), but the difference was not statistically significant. The elbow joints (17.2%) were the most common hypermobile joints and the trunk (0.7%) was the least involved. The children with GJH were younger and had lesser BMI compared to children without GJH (P < 0.05). The prevalence reported in this study among school-aged children was comparable with those reported worldwide.
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Affiliation(s)
- Mohamed Sherif Sirajudeen
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Waly
- Department of Medical Equipment Technology, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mazen Alqahtani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Fahad Aldhafiri
- Department of Public Health, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Hariraja Muthusamy
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Radhakrishnan Unnikrishnan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Rashmi Saibannavar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Wafa Alrubaia
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudi Arabia
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