Joint hypermobility syndrome: a common neuromusculoskeletal disorder?

Authors: Clark, C.J. and Simmonds, J.V.

Journal: Chartered Society of Physiotherapy congress


Purpose The primary purpose of the study was to establish the prevalence of hypermobility and joint hypermobility syndrome (JHS) in women with neuromusculoskeletal disorders attending physiotherapy clinics.

Relevance JHS is an inherited disorder of the connective tissues. It presents as neuromusculoskeletal signs and symptoms including widespread pain without the inflammatory component of a disease like Rheumatoid Arthritis. Hypermobile joints (which occasionally dislocate), arthralgia and soft tissue rheumatism are common clinical findings. Hypermobility is age and ethnically dependant with younger people and those of Asian and African origin being more hypermobile than older Caucasians. Re-attendance, re-injury and prolonged rehabilitation provide a management challenge for clinicians.

Participants A total of 184 females of Omani ethnic origin were recruited. This consisted of the patient group (n=90) who were referred from orthopaedic clinics to hospital physiotherapy clinics and a comparison group (n=90) of hospital staff.

Methods A cross sectional case comparison study design was used. The primary out come measures were the Beighton score and Brighton Criteria. Data on sites of pain was collected on a body chart.

Analysis Data was analysed using SPSS v14 and appropriate parametric and non parametric tests were carried out. The chi-squared test was used to compare between group significance and the simple t-test for joint mobility scores and age.

Results Hypermobility was noted to be significantly more prevalent in the patient group (51%) than the comparison group (30%) (p=0.015). The number of patients with JHS was 55%.

The most common sites of pain presentation for those with JHS were the lumbar spine (63%) and knee (90%). A high percentage of patients with JHS were re-attending clinics (65%).

Conclusions This study has demonstrated a high prevalence of JHS among female patients attending with neuromusculoskeletal disorders. This is similar to that noted in previous research. High incidences of back pain with hypermobility and JHS were reported, these findings are in concordance with findings in rheumatology clinics. A significant number of patients re-attending physiotherapy clinics were diagnosed with JHS.

Implications JHS is a common neuromusculoskeletal disorder in this population. Physiotherapists need to recognise and manage this condition effectively. Epidemiological studies in other ethnic populations are now required.

Source: Manual

Preferred by: Carol Clark