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To investigate whether GJH is a risk factor for injury in elite female soccer players. Cohort study; Level of evidence, 2. Elite female soccer players in the Netherlands were screened at the start of the competitive season. GJH was assessed using the Beighton score. Soccer injuries and soccer exposure were registered throughout the entire season. Similarly, GJH was not a significant risk factor for thigh, knee, or ankle injuries evaluated separately. This study indicates that GJH is not a risk factor for injuries in elite female soccer players, irrespective of Beighton score cutoff point.

Development and validation of self-reported line drawings of the modified Beighton score for the assessment of generalised joint hypermobility. The impracticalities and comparative expense of carrying out a clinical assessment is an obstacle in many large epidemiological studies.

The purpose of this study was to develop and validate a series of electronic self-reported line drawing instruments based on the modified Beighton scoring system for the assessment of self-reported generalised joint hypermobility. Five sets of line drawings were created to depict the 9-point Beighton score criteria. Each instrument consisted of an explanatory question whereby participants were asked to select the line drawing which best represented their joints. Fifty participants completed the self-report online instrument on two occasions, before attending a clinical assessment.

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A blinded expert clinical observer then assessed participants' on two occasions, using a standardised goniometry measurement protocol. Validity of the instrument was assessed by participant-observer agreement and reliability by participant repeatability and observer repeatability using unweighted Cohen's kappa k. Validity and reliability were assessed for each item in the self-reported instrument separately, and for the sum of the total scores. An aggregate score for generalised joint hypermobility was determined based on a Beighton score of 4 or more out of 9.

Observer-repeatability between the two clinical assessments demonstrated perfect agreement k 1. Self-reported participant-repeatability was lower but it was still excellent k 0. The participant-observer agreement was excellent k 0. Validity was excellent for the self-report instrument, with a good sensitivity of 0. The self-reported instrument provides a valid and reliable assessment of the presence of generalised joint hypermobility and may have practical use in epidemiological studies.

Mechanisms underlying reflux symptoms and dysphagia in patients with joint hypermobility syndrome, with and without postural tachycardia syndrome. The joint hypermobility syndrome JHS is a common non-inflammatory connective tissue disorder which frequently co-exists with postural tachycardia syndrome PoTS , a form of orthostatic intolerance. Gastrointestinal symptoms and dysmotility have been reported in PoTS. Dysphagia and reflux are common symptoms in JHS, yet no studies have examined the physiological mechanism for these, subdivided by PoTS status.

A large proportion of JHS patients with esophageal symptoms have true reflux-related symptoms or mild esophageal hypomotility, and this is more likely if they have PoTS. Nationwide population-based cohort study of celiac disease and risk of Ehlers-Danlos syndrome and joint hypermobility syndrome. Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials. This study assessed the literature to determine the efficacy and effectiveness of physiotherapy and occupational therapy interventions in the treatment of people with benign joint hypermobility syndrome BJHS.

All clinical trials comparing the clinical outcomes of Occupational Therapy and Physiotherapy interventions compared to non-treatment or control intervention for people with BJHS were included. Of the search results, 3 clinical studies satisfied the eligibility criteria. While there is some support for exercise-based intervention, there is insufficient research to determine the optimal mode, frequency, dosage or type of exercise which should be delivered.

There is insufficient research exploring the clinical outcomes of a number of interventions including sensory integration, positioning and posture management and education. Longer term, rigorous multi-centre randomised controlled trials are warranted to begin to assess the clinical and cost-effectiveness of interventions for children and adults with BJHS.

Implications for Rehabilitation There is an evidence-base to support clinician's use of proprioceptive-based exercises in adults, and either tailored or generalised physiotherapy regimes for children with BJHS. Until further multi-centre trials are conducted assessing the clinical and cost-effectiveness of interventions for children and adult with BJHS, clinical decision-making should be. Within the multidisciplinary team, physical therapy plays a central role in management of individuals with hypermobility related disorders.

However, many physical therapists are not familiar with the diagnostic criteria, prevalence, common clinical presentation, and management. Multicenter randomized controlled trials are warranted to assess the clinical and cost-effectiveness of interventions for children and adults. Until further multicenter trials are conducted, clinical decision-making should be based on theoretical and the current limited research evidence. Clinical study of hereditary disorders of connective tissues in a Chilean population: joint hypermobility syndrome and vascular Ehlers-Danlos syndrome.

Two hundred forty-nine Chilean patients with hereditary disorders of the connective tissues CTDs and 64 control subjects were evaluated for the diagnoses of JHS and VEDS using the validated Brighton criteria, as compared with the traditional Beighton score.

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In addition, the presence of blue sclera was determined, with the degree of intensity graded as mild, moderate, or marked. The typical JHS facial appearance and the "hand holding the head sign" were identified.

JHS is very frequent but usually undiagnosed. The Beighton score is an insufficient method for JHS diagnosis. We recommend that physicians learn to recognize the typical facial features of JHS and be able to identify blue sclera. We also propose that validated hypermobility criteria be routinely used. Further research is needed to determine why the prevalence of JHS is so high in Chile. Hypermobility , the Ehlers-Danlos syndromes and chronic pain. Chronic widespread pain is a common complaint among individuals affected by generalised joint hypermobility.

In the absence of other conditions that cause chronic pain, these individuals are usually diagnosed with joint hypermobility syndrome JHS. JHS is a multifactorial trait with a strong genetic basis, but no specific genetic markers. The Ehlers-Danlos syndromes EDS comprise a heterogeneous group of rare monogenic conditions that are characterised by joint hypermobility , skin and vascular fragility and generalised connective tissue friability, and are caused by genetic defects in an array of extracellular matrix genes. Clinical experience and a limited number of clinical studies show that chronic pain also is common in EDS patients, especially in hEDS.

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Factors likely contributing to the generation and chronicity of pain include nociceptive pain, directly based on structural changes in affected joints , muscle and connective tissue; neuropathic pain; impaired proprioception and muscle weakness; and central sensitisation. These mechanisms are not mutually exclusive, and likely more than one mechanism may be present. Furthermore, anxiety, depression, and other variables may influence the phenotype.

In view of the high prevalence of these underrecognised conditions, future studies addressing the nature and mediators of chronic pain are needed in order to potentially identify novel targets for. Altered knee joint neuromuscular control during landing from a jump in year old children with Generalised Joint Hypermobility. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability.

There was no difference in jump length between groups. Reduced Semitendinosus activity was seen in GJH after landing, but with no compensatory Gastrocnemius Medialis activity. Reduced pre and post-activation of the Semitendinosus may present a risk factor for traumatic knee injuries as ACL ruptures in GJH with knee hypermobility.

Published by Elsevier Ltd.. Recently, some researchers highlighted an unexpected association between these two clinical entities.

This happens in a scenario of increasing awareness on the protean detrimental effects that congenital anomalies of the connective tissue may have on human health and development. To review pertinent literature to identify possible connections between ADHD and GJH, special emphasis was put on musculoskeletal pain and syndromic presentations of GJH, particularly the hypermobile Ehlers-Danlos syndrome. A comprehensive search of scientific databases and references lists was conducted, encompassing publications based on qualitative and quantitative research.

Impaired coordination and proprioception, fatigue, chronic pain, and dysautonomia are identified as potential bridges between ADHD and JH. Based on these findings, a map of the pathophysiological and psychopathological pathways connecting both conditions is proposed. Although ADHD and JH are traditionally separated human attributes, their association may testify for the dyadic nature of mind-body connections during critical periods of post-natal development. Such a mixed picture has potentially important consequences in terms of disability and deserves more clinical and research attention.


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Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension. Background Knee pain in children with Joint Hypermobility Syndrome JHS is traditionally managed with exercise, however the supporting evidence for this is scarce. No trial has previously examined whether exercising to neutral or into the hypermobile range affects outcomes.

This study aimed to i determine if a physiotherapist-prescribed exercise programme focused on knee joint strength and control is effective in reducing knee pain in children with JHS compared to no treatment, and ii whether the range in which these exercises are performed affects outcomes. Methods A prospective, parallel-group, randomised controlled trial conducted in a tertiary hospital in Sydney, Australia compared an 8 week exercise programme performed into either the full hypermobile range or only to neutral knee extension, following a minimum 2 week baseline period without treatment.

Randomisation was computer-generated, with allocation concealed by sequentially numbered opaque sealed envelopes. Knee pain was the primary outcome. Quality of life, thigh muscle strength, and function were also measured at i initial assessment, ii following the baseline period and iii post treatment.

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Significant improvements in child-reported maximal knee pain were found following treatment, regardless of group allocation with a mean Conversely, parent. Hypermobile Ehlers-Danlos syndrome a. The hypermobile type of Ehlers-Danlos syndrome hEDS is likely the most common hereditary disorder of connective tissue. Many patients report activity-related pain and some go on to have daily pain.

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Two undifferentiated syndromes have been used to describe these manifestations- joint hypermobility syndrome and hEDS. Both are clinical diagnoses in the absence of other causation. Current medical literature further complicates differentiation and describes multiple associated symptoms and disorders. Herein, we review and summarize the literature as a better clinical description of this type of connective tissue disorder.

Correlation between hypermobility score and injury rate in artistic gymnastics. Generalized Joint Hypermobility GJH is suggested as a contributing factor for injuries in young athletes and adults. It is presumed that GJH causes decreased joint stability, thereby increasing the risk of joint and soft tissue injuries during sports activities.

This study observed 24 artistic gymnasts years old , members of Qatar National Team in artistic gymnastics.


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We examined the Beighton joint hypermobility screen and a seasonal injury survey. The gymnasts characteristics age, gender and gymnastics characteristics training per day and number of years in training artistic gymnastics and its' relations to injury rate were also included. The most common injury was the lower back pain injury, followed by knee, shoulder, hip and ankle injuries. According to this study there is no correlation between GJH rate and injury rate in artistic gymnasts in Qatar. Total training period in gymnastics have greater contribution in injury rate.