Does the item ‘hands on floor’ add value to the Beighton score in identifying joint hypermobility?

Corten, Lieselotte; Ferguson, Gillian; Smits-Engelsman, B.C.M.

doi:10.5152/eurjrheum.2020.19185

Cited by 8 publications

(18 citation statements)

References 21 publications

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“…It has been suggested that the presence of muscle retractions and an inability to perform the manoeuvre may actually be indicative of hypermobility [27]. One study has concluded that while this manoeuvre has high specificity (93.7%), its sensitivity is so low (13.8%) that it adds no additional value to the BS [28]. These findings, in which the vast majority of confirmed patients are unable to perform the very manoeuvre contributing to their diagnosis, should call into question its continued inclusion in the BS for diagnostic purposes.…”

Section: Validity Of the Beighton Scorementioning

confidence: 99%

“…The same finding has also been noted in hypermobile children, even before age-related loss of hypermobility is expected. In a study of over 400 children between 6 and 11 years of age, 86% of those who were hypermobile (BS ≥ 5) could not perform the manoeuvre [ 28 ], while another in over 200 children aged 10–13 years, found 84% of hypermobile males (BS ≥ 4) and 78% of hypermobile females (BS ≥ 5) could not perform the forward flexion manoeuvre [ 29 ]. When compared with children without GJH, no differences were found between the groups in their abilities, and further lack of differences was found in the flexibility of the trunk and the muscle–hip complex [ 29 ].…”

Section: Validity Of the Beighton Scorementioning

confidence: 99%

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The Beighton Score as a measure of generalised joint hypermobility

2021

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The Beighton Score (BS) is a set of manoeuvres in a nine-point scoring system, used as the standard method of assessment for Generalised Joint Hypermobility (GJH). It was originally developed as an epidemiological tool used in screening large populations for GJH, but later adopted as a clinical tool for diagnostic purposes. Its ability to truly reflect GJH remains controversial, as joints within the scoring system are predominantly of the upper limb and disregard many of the major joints, preventing a direct identification of GJH. Furthermore, a consistent finding in the literature whereby the BS failed to identify hypermobility in joints outside the scoring system suggests its use as an indirect indicator of GJH is also not viable. As such, the collective findings of this review demonstrate a need for a change in clinical thinking. The BS should not be used as the principle tool to differentiate between localised and generalised hypermobility, nor used alone to exclude the presence of GJH. Greater emphasis should be placed on a clinician’s judgement to identify or exclude GJH, according to its full definition.

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Section: Validity Of the Beighton Scorementioning

confidence: 99%

Section: Validity Of the Beighton Scorementioning

confidence: 99%

The Beighton Score as a measure of generalised joint hypermobility

2021

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“…Factors contributing to joint hypermobility and joint instability are similar and are listed in table 1. The BS is a modification of the 1964 Carter and Wilkinson scoring system developed by Beighton and Horan in 1969 to establish prevalence of GJH in an African population (Corten et al, 2020). It is the most commonly used method for identifying GJH.…”

Section: Ligament Laxitymentioning

confidence: 99%

“…Prevalence of GJH ranges between 2%-57% of the general population (Castori et al ., 2017), but is significantly higher in African, Asian, younger individuals and females (Corten et al ., 2020). A systematic review and meta-analysis of Global GJH prevalence in children and adolescents by Sobhani-Eragi et al ., (2021) reported a value of 34.1% (95% CI: 33.3%–34.8%).…”

Section: Introductionmentioning

confidence: 99%

“…Criticisms of using the BS to establish GJH include: Neither Carter and Wilkinson (1964) nor Beighton et al (1973) provided any evidence-based justification for the selection of joints (Malek et al ., 2021) Only 4 joint sites are measured (Malek et al ., 2021) Validity not adequately researched (Juul-Kristensen et al ., 2017) Appropriateness for paediatric populations (Patel, et al ., 2017) Inability to capture degree of hypermobility Developed as an epidemiological tool (Malek et al ., 2021) (Beighton et al ., 1973) Inclusion of ligament laxity measurement (Corten et al, 2020) (Castori et al ., 2017) No consensus-based cut-off values (Remvig et al ., 2014) Bias towards upper limb hypermobility, that might fail to capture lower limb hypermobility resulting in false negatives (Ferrari et al ., 2005) Only assesses ROM in 2 dimensions. For some joints ROM occurs in multi-dimensions There are no consensus values for normal ROM (Soucie et al ., 2011) (Moromizato et al ., 2016) (Remvig et al ., 2007) and the values chosen in the BS scoring system are based on tradition, rather than evidence …”

Section: Introductionmentioning

confidence: 99%

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A Systematised Review of the Beighton Score Compared with Other Commonly Used Measurement Tools for Assessment and Identification of Generalised Joint Hypermobility (GJH)

Alexander

2022

Preprint

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This systematic review compares the validity and reliability of the Beighton Score to those of other commonly used scores for identifying generalised joint hypermobility (GJH). Inclusion criteria: English language, studies on humans, all types of study designs, publications in academic journals, publications from the year two thousand onwards, publications in print and theses. Exclusion criteria: studies not in English, studies measuring single joints only, studies published before the year 2000, cadaveric studies, papers with only abstracts available. An electronic literature search was undertaken of Pub Med/MEDLINE, Embase, Scopus, Cochrane Database, SPORT Discus, Pedro databases, followed by a manual search between August and November 2021. The final review included 73 papers. The PRISMA (2021) COSMIN (2010) guidelines and CASP (2019) criteria were used to evaluate methodological quality and bias. The Beighton Score’s intra-rater and inter-rater reliability ranged between ICC 0.74-0.99 and ICC 0.72-0.98 respectively. The BS has reasonable intra-rater and inter-rater reliability, however validity cannot be accurately determined as incorporation bias was identified as a major issue in study methodology, not previously identified in the literature. Paucity of data prevented accurate assessment of other scoring systems. Urgent research is required to clarify these issues and compare the BS to other tests. No source of funding was received in in undertaking this review. The author has no conflict of interests to disclose. This review was not registered. This review has been conducted as closely as possible in accordance with the PRISMA guidelines for reporting systematic reviews.

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Association of joint hypermobility with range of cervical motion and its impact on the motor unit loss in patients with Hirayama disease

Chen,

Yang,

Zhu

et al. 2023

Muscle and Nerve

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Introduction/AimsSome patients with Hirayama disease (HD) may have generalized joint hypermobility (GJH), which may excessively increase cervical range of motion (ROM) and then worsen the HD. The purpose of this study was to identify the frequency of GJH in HD patients and to analyze the effect of GJH on cervical ROM and the severity of HD.MethodsThe Beighton scoring system (≥4) was used to diagnose GJH in 84 HD patients. All patients underwent assessments of cervical‐flexion/extension ROM; motor unit number estimation in bilateral abductor pollicis brevis (APB) muscles; handgrip strength; and the disabilities of the arm, shoulder, and hand assessments.ResultsConcomitant GJH was identified in 20 (23.8%) HD patients. The HD patients with GJH exhibited greater cervical‐flexion (P < .001) and cervical‐extension (P = .033) ROM than those without GJH. Both greater single motor unit potential amplitudes (symptomatic side: P = .005; less‐symptomatic side: P = .011) and lower motor unit numbers (symptomatic side: P = .008; less‐symptomatic side: P = .013) in bilateral APB, along with lower compound muscle action potential amplitudes on the symptomatic‐side APB (P = .039), were observed in patients with GJH than those without GJH. There was a mild negative correlation between motor unit number and cervical‐flexion ROM in HD patients (symptomatic side: r = −0.239, P = .028; less‐symptomatic side: r = −0.242, P = .027).DiscussionThe frequency of GJH in HD patients may be higher than in the general population. Importantly, GJH may exacerbate excessive cervical‐flexion ROM, thereby worsening motor unit loss in HD patients. A cautious approach should be taken when treating HD due to possible comorbid GJH.

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Does the item ‘hands on floor’ add value to the Beighton score in identifying joint hypermobility?

Cited by 8 publications

References 21 publications

The Beighton Score as a measure of generalised joint hypermobility

The Beighton Score as a measure of generalised joint hypermobility

A Systematised Review of the Beighton Score Compared with Other Commonly Used Measurement Tools for Assessment and Identification of Generalised Joint Hypermobility (GJH)

Association of joint hypermobility with range of cervical motion and its impact on the motor unit loss in patients with Hirayama disease

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