Joint hypermobility syndrome and developmental coordination disorder in adults.
Authors: Clark, C.J.
Journal: Newsletter Hypermobility Syndrome Association
The research we are currently undertaking is aimed at establishing if those with JHS report coordination difficulties associated with developmental coordination disorder (DCD) and if this is related to pain, physical activity and quality of life.
Developmental coordination disorder is clumsiness or poor coordination affecting the ability to carry out everyday activities. DCD is also known as dyspraxia.
Originally DCD was thought to occur only in children and that children grew out of their coordination difficulties. More recently it has been acknowledged that coordination difficulties persist into adulthood.
Children with JHS have been shown to share the same functional difficulties as children with DCD and children with DCD report hypermobile joints and sometimes pain. Over the last fifteen years research has suggested that joint pain affects the way in which muscles work. If muscles do not work in the way in which they were designed then this can lead to the continuation of pain and fatigue.
Similarly, impaired coordination results in poor movement patterns around joints which may also cause pain and joint instability.
Factors that contribute to stability of a joint are two fold; there are the static (stationary) contributors and dynamic (moveable) contributors. The static contributors relate to the structures that make up a joint these include the bones, the capsule (a fluid filled sack surrounding the joint) and the ligaments. The dynamic contributors to stability are the muscles, tendons and the nervous system which controls the movement of the muscles. There is input from all these structures that help stabilise joints but the most important element is the dynamic contribution.
Physical activity and exercise increase the strength of ligaments, tendons and muscles and improve the efficient activation of muscles therefore contributing to stability of joints and the body as a whole. A reduction in physical activity or exercise has the reverse effect. This affects not only the strength of the ligaments, tendons and muscles but it also affects the efficiency of movement.
At this stage it is clear that regular physical activity and exercise help to stabilise joints, improve muscle efficiency and reduce pain and is of great benefit to those with hypermobile joints.
The significance of establishing a link between JHS and DCD is because for those with JHS there is a predisposition to injury which is related to fragile connective tissues. Coordination difficulties (associated with DCD) impede the efficiency of movement and may be an important contributor to injury and pain in weak tissues, thereby hindering the ability to carry out activity.
In addition impaired coordination slows down recovery following the onset of pain or injury. During a simple task there might be no identifiable movement problems. However, when more complex tasks that challenge the movement systems are attempted inefficient movement patterns persist which are likely to exacerbate injury, pain or fatigue. This aspect needs to be addressed during rehabilitation of those with JHS and DCD.
Preferred by: Carol Clark