Measurement properties of clinical assessment methods for classifying generalized joint hypermobility—A systematic review

Juul-Kristensen, Birgit; Schmedling, Karoline; Rombaut, Lies; Lund, Hans; Engelbert, Raoul

doi:10.1002/ajmg.c.31540

Cited by 157 publications

(170 citation statements)

References 49 publications

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“…The rhythmic gymnasts were categorized as being hypermobile if they scored on 5 or more of 9 variables. 26 Beighton score was assessed clinically and data on UI, menarche, and the female athlete triad were collected by an electronic questionnaire. The data on these variables were collected at a national competition and in a regular club training setting by one examiner only and who was a trained sports physical therapist (MCDG).…”

Section: Methodsmentioning

confidence: 99%

High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance

Gram

Bø

2019

Scandinavian Med Sci Sports

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Urinary incontinence (UI) is common among exercising women, but no studies have been found in rhythmic gymnasts. The aims of the present study were to investigate the prevalence and risk factors for UI in rhythmic gymnasts and the impact of UI on performance. This was a cross-sectional study including all rhythmic gymnasts competing at the highest national and international level in Norway. One hundred and thirty-three gymnasts from 22 sports clubs were invited to participate. Background data and possible risk factors were collected via electronic questionnaires. UI was assessed by Urinary Incontinence short form (ICIQ-UI SF). The "Triad-specific selfreport questionnaire" was applied to assess the female athlete triad. Joint mobility was assessed by Beighton score. Logistic regression analysis was used to assess possible risk factors. One hundred and seven nulliparous rhythmic gymnasts (80.5% response rate) from 21 sports clubs, with mean age of 14.5 (SD 1.6) years, participated in the study. Thirty-four (31.8%) reported UI with 21 (61.8%), 3 (8.8%), 6 (17.6%), and 4 (11.8%) reporting stress, urgency, mixed urinary incontinence, and leakage for no obvious reason, respectively. BMI, hypermobility, menarche, disordered eating, and hours of training were not found to be risk factors for stress urinary incontinence.Twenty-four gymnasts with UI (70.6%) reported incontinence to influence sports performance; 10 (29.4%) reported to be afraid of visible leakage and 5 (14.7%) that the leakage would happen again. Seventy-four (69.1%) had never heard about the pelvic floor. In conclusion, UI is common in rhythmic gymnasts and may influence sports performance. K E Y W O R D Sfemale athletes, pelvic floor, performance, rhythmic gymnastics, urinary incontinence How to cite this article: Gram MCD, Bø K. High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance. Scand J Med Sci Sports. 2020;30:159-165. https ://doi.

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Section: Methodsmentioning

confidence: 99%

High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance

Gram

Bø

2019

Scandinavian Med Sci Sports

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“…The BS consists of a single measure of forward bending at the lower back and testing of bilateral joints (fifth finger extension, elbow extension, knee extension and thumb‐to‐forearm opposition). Scores range from 0/9 with a score of 5/9 consistent with GJH in adults age 18–49 as per the 2017 diagnostic criteria for hEDS (Juul‐Kristensen, Schmedling, Rombaut, Lund, & Engelbert, ). The cutoff for GJH changes with age with a score of 4/9 considered GJH in adults over age 50 and a score of 6/9 considered GJH in children and adolescents under age 18.…”

Section: Introductionmentioning

confidence: 99%

“…Scores range from 0/9 with a score of 5/9 consistent with GJH in adults age 18-49 as per the 2017 diagnostic criteria for hEDS (Juul-Kristensen, Schmedling, Rombaut, Lund, & Engelbert, 2017). The cutoff for GJH changes with age with a score of 4/9 considered GJH in adults over age 50 and a score of 6/9 considered GJH in children and adolescents under age 18.…”

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confidence: 99%

Utilization of the 2017 diagnostic criteria for hEDS by the Toronto GoodHope Ehlers–Danlos syndrome clinic: A retrospective review

McGillis

Mittal

Mina

et al. 2019

American J of Med Genetics Pt A

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The new 2017 diagnostic criteria for hypermobile Ehlers–Danlos Syndrome (hEDS) provide a framework for diagnosing hEDS but are more stringent than the previous Villefranche criteria. Our clinical experience at the GoodHope EDS clinic was that the 2017 criteria left many highly symptomatic patients without a diagnosis of hEDS. We conducted a retrospective cohort study to confirm our clinic experience and assess the accuracy of the 2017 diagnostic criteria for hEDS in patients who had a previous hEDS diagnosis based on the Villefranche criteria. Our study found that 15% (n = 20 of 131) of patients with a prior diagnosis of hEDS met the 2017 diagnostic criteria, and many of the traits used to distinguish hEDS were not significantly more frequent in patients who met 2017 criteria versus those who did not. In both groups objective systemic manifestations were found less frequently than subjective systemic manifestations. Beighton score (BS) as assessed by primary care practitioner was found to be higher than assessment by EDS practitioner in 81% (n = 74 of 91) of cases. Generalized joint hypermobility was confirmed in only 46% (n = 51 of 111) of patients who had a previous diagnosis of hEDS. Higher BS did not correlate with increased number of systemic manifestations in our cohort. Common comorbidities of hEDS were found with similar frequency in those who met 2017 criteria and those who did not. Based on our cohort, the 2017 hEDS diagnostic criteria require refinement to improve its diagnostic accuracy.

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“…Kirby and Davies (2007) reported a significant increase in the prevalence of JHS in children with DCD (37%) vs. typically developing children (7.4%) (p < 0.05) (Kirby & Davies, 2007). These authors used the five-point questionnaire to measure JH, which is more commonly used in the adult population and has not been validated for the paediatric population (Juul-Kristensen, Schmedling, Rombaut, Lund, & Engelbert, 2017). (Blank et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Hypermobility, developmental coordination disorder and physical activity in an Irish paediatric population

Moore

Rand

Simmonds

2019

Musculoskeletal Care

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Objective The primary aim of the study was to explore the prevalence of generalized joint hypermobility (GJH) and generalized hypermobility spectrum disorder (gHSD) using the new classification system in a community paediatric physiotherapy service in Ireland. The second aim was to explore the relationship between GJH, gHSD and physical activity level, while considering the association of probable developmental coordination disorder (pDCD). Methods A case‐controlled cross‐sectional study of children aged 6–12 years, recruited from the community paediatric physiotherapy department (n = 32) and a local school (n = 41), was carried out. A Beighton score of ≥6/9 distinguished GJH. The new framework for hypermobility spectrum disorder (HSD) was used. Self‐reported physical activity level was measured using the Physical Activity Questionnaire—Older Children. A parent‐reported validated questionnaire screened for pDCD. Results The prevalence of GJH was 21.9% of children attending physiotherapy. One child in the physiotherapy group was identified as having gHSD, with a prevalence of 3.1%. There was no significant difference in physical activity level between children with and without GJH attending physiotherapy (independent samples t‐test, p = 0.28). Probable developmental coordination disorder (pDCD) was observed in 71.9% of children attending physiotherapy. There was no significant difference in the number of children with pDCD in those with and without GJH (Fisher's exact test, p = 0.370). Conclusions This study was the first to explore the prevalence of GJH and gHSD in the paediatric physiotherapy population in Ireland. The presence of GJH did not affect self‐reported physical activity level or motor coordination in children attending physiotherapy.

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Measurement properties of clinical assessment methods for classifying generalized joint hypermobility—A systematic review

Cited by 157 publications

References 49 publications

High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance

High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance

Utilization of the 2017 diagnostic criteria for hEDS by the Toronto GoodHope Ehlers–Danlos syndrome clinic: A retrospective review

Hypermobility, developmental coordination disorder and physical activity in an Irish paediatric population

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