Generalized Joint Hypermobility and Risk of Lower Limb Joint Injury During Sport

Pacey, Verity; Nicholson, Leslie L.; Adams, Roger; Munn, Joanne; Munns, Craig F

doi:10.1177/0363546510364838

Cited by 138 publications

(145 citation statements)

References 42 publications

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“…The findings of a systematic review with meta-analysis suggests that hypermobility increased the risk of knee joint injury during contact sports, although there was no evidence that hypermobility affected the risk of ankle joint injury (Pacey et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

Konopinski

Graham

Johnson

et al. 2016

Physical Therapy in Sport

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Football: a multi-site cohort study

ABSTRACTBackground: A recent study demonstrated joint hypermobility increased the incidence of injury in an elite football team utilising a univariate statistical model. Objectives:To compare injury incidence between hypermobile and non-hypermobile elite football players incorporating a multi-site design and multivariate inferential statistics.Methods: 80 players comprising 3 English Championship football teams were followed prospectively during the 2012-2013 season. Joint hypermobility was assessed according to the 9-point Beighton Criteria at the start of the study period. A cut-off score of ≥4 categorised a participant as hypermobile. Player exposure and time-loss injuries were recorded throughout.Results: Mean ± standard deviation incidence of injuries was 9.2 ± 10.8 injuries/1000h. The prevalence of hypermobility was 8.8%. Hypermobiles had a tendency for higher injury incidence (mean [95% confidence interval] difference, 5.2 [0.9-2.7] injuries/1000 h; p = 0.06). Cox regression analyses found training exposure to be highly significant in terms of injury risk (p < 0.001) for all participants. Non-hypermobiles had a lower injury risk (p = 0.11), according to the Cox model, which is suggestive but not conclusive that hypermobility predisposes injury risk.Conclusions: Hypermobility showed a trend towards increased risk of injury. Training exposure is a significant injury risk factor in elite football.

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Section: Introductionmentioning

confidence: 99%

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

Konopinski

Graham

Johnson

et al. 2016

Physical Therapy in Sport

View full text Add to dashboard Cite

Football: a multi-site cohort study

ABSTRACTBackground: A recent study demonstrated joint hypermobility increased the incidence of injury in an elite football team utilising a univariate statistical model. Objectives:To compare injury incidence between hypermobile and non-hypermobile elite football players incorporating a multi-site design and multivariate inferential statistics.Methods: 80 players comprising 3 English Championship football teams were followed prospectively during the 2012-2013 season. Joint hypermobility was assessed according to the 9-point Beighton Criteria at the start of the study period. A cut-off score of ≥4 categorised a participant as hypermobile. Player exposure and time-loss injuries were recorded throughout.Results: Mean ± standard deviation incidence of injuries was 9.2 ± 10.8 injuries/1000h. The prevalence of hypermobility was 8.8%. Hypermobiles had a tendency for higher injury incidence (mean [95% confidence interval] difference, 5.2 [0.9-2.7] injuries/1000 h; p = 0.06). Cox regression analyses found training exposure to be highly significant in terms of injury risk (p < 0.001) for all participants. Non-hypermobiles had a lower injury risk (p = 0.11), according to the Cox model, which is suggestive but not conclusive that hypermobility predisposes injury risk.Conclusions: Hypermobility showed a trend towards increased risk of injury. Training exposure is a significant injury risk factor in elite football.

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“…Furthermore, Milles and associates reported that individuals with anterior knee pain who had increased midfoot mobility were more likely to experience a reduction in their symptoms when treated with pre-fabricated orthoses [6]. Foot hypermobility has also been associated with an increased risk of other injuries in sports, particularly the lower extremity [7]. Investigators have reported a relationship between foot mobility and such conditions as plantar fasciitis [8], lower extremity osteoarthritis [9], medial tibial stress syndrome [10,11] and anterior cruciate ligament injuries in females [12].…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of the Sit-To-Stand Test to assess Global Foot Mobility

Cornwall¹,

Lane²,

Norwood³

et al. 2017

J Sports Med Ther

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SUMMARYThe Sit-to-Stand test (STST) involves comparing the change in a person's non-weight-bearing and weightbearing foot posture to quickly classify a person's overall foot mobility. Despite the simplicity of the test, its reliability and validity has not been established. The purpose of this study is to determine the intra-rater and inter-rater reliability of the STST as well as its validity. Ninety-seven subjects with a mean age of 25 years (±3.7) participated in the study. Each subject's foot posture from non-weight-bearing to weight-bearing was evaluated by two different raters. Each rater classifi ed each subject's change in foot posture as "Hypomobile", "Normal" or "Hypermobile". This same procedure was repeated approximately one week later without the raters being able to review what their original classifi cation for that subject had been. The subjects also had their foot mobility quantifi ed by measuring the height and width of their dorsal arch in both non-weight-bearing and weight-bearing. These quantitative measures of foot mobility were then classifi ed as "Hypomobile", "Normal", or "Hypermobile" using quartiles. A series of Cohen's Kappa coeffi cients were used to assess the amount of agreement between the visual classifi cations by each rater as well as the classifi cation between the observational and objective classifi cations. The between-day Kappa coeffi cients ranged from 0.613 to 0.719 and the inter-rater Kappa coeffi cients ranged from 0.473 to 0.531. The Kappa coeffi cients between the visual and quantitative classifi cations ranged from 0.281 to 0.436. The STST should therefore be used with caution because of its moderate between-rater reliability and validity.

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“…It is a condition in which most of an individual's synovial joints have a range of motion (ROM) beyond their normal limits [2,3]. It has been suggested that an abnormal ratio of Type III to Type I collagen results in the decreased tissue stiffness common in GJH, where thin and elastic Type III collagen becomes more prevalent within the soft tissue matrix [4].…”

Section: Introductionmentioning

confidence: 99%

“…Due to GJH's ability to reduce joint stability, it has been linked with an increased risk of musculoskeletal injury and is proposed as a risk factor for injuries to the ankle, knee and shoulder joints [3,[10][11][12][13][14]. In its extremes, GJH is associated with hereditary connective tissue disorders such as Marfan's Syndrome and Ehlers-Danlos Syndrome with chronic pain and fatigue major determinants of reduced quality of life [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Such limitations include: poorly controlling the time interval between measurements, goniometer measurement error, variation in verbal instructions and soft tissue warm-up before or during testing. Nonetheless, both the Beighton and Contompasis scores have been used in clinical and research practice [3,6,9,21]. It is therefore important that clinicians and researchers understand the psychometric properties of these scores when considering their future adoption.…”

Section: Introductionmentioning

confidence: 99%

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Inter- and intra-rater reliabilities of the Beighton Score compared to the Contompasis Score to assess Generalised Joint Hypermobility

Vallis¹,

Wray

Smith

2015

MYOPAIN

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Objectives: 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 intraand inter-rater reliability of the Beighton Score to the Contompasis Score to assess GJH. Methods:This was an observational study assessing 36 pain-free participants; 27 females and nine males; aged 18 to 32 years. Participants were assessed in random order, by two researchers over two sessions to determine intra-and inter-rater analyses. Intraclass Correlation Coefficient (ICC) and weighted Kappa statistics were used to calculate the level of agreement. Conclusions:The present study provides an indication of the measurement capabilities of the Beighton and Contompasis Scores. The Beighton score appears to be superior compared to the Contompasis score particularly based on inter-rater reliability.

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Generalized Joint Hypermobility and Risk of Lower Limb Joint Injury During Sport

Abstract: Sport participants with generalized joint hypermobility have an increased risk of knee joint injury during contact activities but have no altered risk of ankle joint injury.

Cited by 138 publications

References 42 publications

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

Reliability and validity of the Sit-To-Stand Test to assess Global Foot Mobility

Inter- and intra-rater reliabilities of the Beighton Score compared to the Contompasis Score to assess Generalised Joint Hypermobility

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