The examination of the musculoskeletal system based only on the evaluation of pelvic-hip complex muscle and trunk flexibility may lead to failure to screen children for generalized joint hypermobility

PLoS One. 2015 Mar 18;10(3):e0121360. doi: 10.1371/journal.pone.0121360. eCollection 2015.

Abstract

Objective: The aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH).

Design: A cross-sectional study.

Setting: Center of Body Posture in Olsztyn, North East Poland.

Participants: The study included 136 females and 113 males aged 10-13 years.

Main outcome measures: In order to assess muscle flexibility, the straight leg raise (SLR) test (for hamstring) and modified Thomas test for one- (O-JHF) and two-joint (T-JHF) hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF) and lateral trunk flexion (LTF) tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males). The analysis was carried out separately for females and males.

Results: There were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively), O-JHF (p = 0.89, p = 0.35 for females and males, respectively), T-JHF (p = 0.77, p = 0.4 for females and males, respectively), FTF (p = 0.19, p = 0.84 for females and males, respectively) and LTF (p = 0.58, p = 0.35 for females and males, respectively) tests results.

Conclusions: Clinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10-13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth.

MeSH terms

  • Adolescent
  • Child
  • False Negative Reactions
  • Female
  • Hip / physiopathology*
  • Humans
  • Joint Instability / diagnosis*
  • Joint Instability / physiopathology*
  • Male
  • Movement
  • Muscles / physiopathology*
  • Pelvis / physiopathology*
  • Pilot Projects

Grants and funding

The authors received no specific funding for this work.