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Juul-Kristensen B, Østengaard L, Hansen S, Boyle E, Junge T, Hestbaek L. Generalised joint hypermobility and shoulder joint hypermobility, - risk of upper body musculoskeletal symptoms and reduced quality of life in the general population. BMC Musculoskelet Disord 2017; 18:226. [PMID: 28558742 PMCID: PMC5450151 DOI: 10.1186/s12891-017-1595-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/22/2017] [Indexed: 12/16/2022] Open
Abstract
Background Generalised Joint Hypermobility (GJH) is a hereditary condition with an ability to exceed the joints beyond the normal range. The prevalence of GJH in the adult population and its impact on upper body musculoskeletal health and quality of life has mostly been studied in selected populations. The aims of this study were therefore, firstly to study the prevalence of GJH and GJH including shoulder hypermobility (GJHS), in the general Danish adult population; secondly to test the associations between GJH or GJHS and upper body musculoskeletal symptoms and health-related quality of life (HRQoL). Methods The study was cross-sectional where 2072 participants, aged 25–65, randomly extracted from the Danish Civil Registration System), were invited to answer a questionnaire battery (Five-Part Questionnaire for classification of GJH, Standardised Nordic Questionnaire for musculoskeletal symptoms, EuroQoL-5D for HRQoL). Results Totally 1006 (49%) participants responded. The prevalence of GJH and GJHS were 30% (n = 300) and 5% (n = 51), respectively. Compared with Non GJH (NGJH), participants with GJH and GJHS had Odds Ratio (OR) of 1.5-3.5 for upper body musculoskeletal symptoms within the last 12 months (mostly shoulders and hands/wrists). GJH and GJHS also had OR 1.6–4.4 for being prevented from usual activities, mostly due to shoulder and neck symptoms. Furthermore, GJH and GJHS had OR 2.2–3.1 for upper body musculoskeletal symptoms lasting for more than 90 days (neck, shoulders, hand/wrists), and 1.5–3.5 for reduced HRQoL (all dimensions, but anxiety/depression) compared with NGJH. Generally, most OR for GJHS were about twice as high as for those having GJH alone. Conclusions GJH and GJHS are frequently self-reported musculoskeletal conditions in the Danish adult population. Compared with NGJH, GJH and especially GJHS, present with higher OR for upper body musculoskeletal symptoms, more severe symptoms and decreased HRQoL.
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Affiliation(s)
- Birgit Juul-Kristensen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Lasse Østengaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sebrina Hansen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Eleanor Boyle
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tina Junge
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark
| | - Lise Hestbaek
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, Francomano C. Pain management in the Ehlers-Danlos syndromes. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:212-219. [DOI: 10.1002/ajmg.c.31554] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Tinkle B, Castori M, Berglund B, Cohen H, Grahame R, Kazkaz H, Levy H. Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:48-69. [PMID: 28145611 DOI: 10.1002/ajmg.c.31538] [Citation(s) in RCA: 263] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The hypermobile type of Ehlers-Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue. It has been described largely in those with musculoskeletal complaints including joint hypermobility, joint subluxations/dislocations, as well as skin and soft tissue manifestations. Many patients report activity-related pain and some go on to have daily pain. 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. The current EDS nosology combines these two entities into the hypermobile type of EDS. Herein, we review and summarize the literature as a better clinical description of this type of connective tissue disorder. © 2017 Wiley Periodicals, Inc.
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Baeza-Velasco C, Grahame R, Bravo JF. A connective tissue disorder may underlie ESSENCE problems in childhood. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 60:232-242. [PMID: 27802895 DOI: 10.1016/j.ridd.2016.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Ehlers-Danlos syndrome hypermobility type, also known as Joint Hypermobility Syndrome (EDS-HT/JHS), is the most common hereditary disorder of the connective tissue (HDCT). It is characterized by tissue fragility, joint hypermobility and a wide range of articular and non-articular manifestations, which often appear in infancy. The clinical picture of EDS-HT/JHS is poorly known by the medical community, as is the presence of "ESSENCE" (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) problems in affected children. AIM The present work reviews the clinical and empirical evidence for ESSENCE difficulties in children with EDS-HT/JHS. METHOD A narrative review of the literature was undertaken following a comprehensive search of scientific online databases and reference lists. This included publications of quantitative and qualitative research. RESULTS Motor abnormality, hyperactivity/hypoactivity, inattention, speech/language, social interaction, behavioral, sleep, feeding and emotional problems are ESSENCE difficulties for which there is some evidence of an association with EDS-HT/JHS. CONCLUSION Children with EDS-HT/JHS present ESSENCE problems that often coexist and tend to be recognized before the HDCT. Clinicians encountering children with ESSENCE problems should consider the possibility of an underlying HDCT such as EDS-HT/JHS, probably influencing neurodevelopmental attributes in a subgroup of children. Awareness of these interconnected clinical problems might help improve early referral, diagnosis and treatment of EDS-HT/JHS.
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Affiliation(s)
- Carolina Baeza-Velasco
- Department of Psychology, Laboratory of Psychopathology and Health Process, University Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France.
| | - Rodney Grahame
- Division of Medicine, University College London, London, UK
| | - Jaime F Bravo
- Medical School, University of Chile, Santiago, Chile; Rheumatology Unit, San Juan de Dios Hospital, Santiago, Chile
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Stettler M, Luder G, Schmid S, Mueller Mebes C, Stutz U, Ziswiler HR, Radlinger L. Passive anterior tibial translation in women with and without joint hypermobility: an exploratory study. Int J Rheum Dis 2016; 21:1756-1762. [PMID: 27456472 DOI: 10.1111/1756-185x.12917] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Generalized joint hypermobility (GJH) is a frequent entity, which is still not fully understood. Symptoms associated with GJH are musculoskeletal disorders, decreased balance, impaired proprioception and chronic pain. The purpose of this study was to compare the passive anterior tibial translation (TT) in terms of distance and corresponding force between normomobile (NM) and hypermobile (HM) as well as between NM, symptomatic (HM-s) and asymptomatic (HM-as) hypermobile women. METHODS A total of 195 women, 67 NM and 128 HM, whereof 56 were further classified as HM-s and 47 as HM-as, participated in this study. Passive TT was measured using an adapted Rolimeter. A manual traction force was applied and the distance of the translation measured. For the analysis, maximal translation (TTmax) and the respective force as well as the distance at 40N (TTF40) and 80N (TTF80) traction force were determined. The NM and HM groups were compared using independent samples t-tests, whereas the NM, HM-s and HM-as groups were compared using one-way analyses of variance with Tukey post hoc tests (significance level P ≤ 0.05). RESULTS Comparisons revealed higher values for the variables TTmax, TTF40 and TTF80 in the HM compared to the NM group. In addition, TTmax and TTF80 were found to be higher in the HM-s compared to the NM group. CONCLUSIONS HM women showed significantly higher TT distances, which were even more accentuated in those having symptoms. The findings point toward less passive stability of the knee joint and thus maybe a need of higher muscle activation in order to stabilize the joint.
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Affiliation(s)
- Matthias Stettler
- Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Gere Luder
- Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.,Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland
| | - Stefan Schmid
- Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | | | - Ursula Stutz
- Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland
| | | | - Lorenz Radlinger
- Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
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Ponnusamy V, Owens AP, Purkayastha S, Iodice V, Mathias CJ. Orthostatic intolerance and autonomic dysfunction following bariatric surgery: A retrospective study and review of the literature. Auton Neurosci 2016; 198:1-7. [DOI: 10.1016/j.autneu.2016.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/29/2016] [Accepted: 05/16/2016] [Indexed: 01/24/2023]
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Rossettini G, Rondoni A, Schiavetti I, Tezza S, Testa M. Prevalence and risk factors of thumb pain in Italian manual therapists: An observational cross-sectional study. Work 2016; 54:159-69. [DOI: 10.3233/wor-162289] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy
| | - Angie Rondoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy
| | - Irene Schiavetti
- Department of Health Sciences, Biologist Biostatistic, University of Genova – Biostatistics Unit, Genova, Italy
| | | | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy
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To M, Simmonds J, Alexander C. Where do People with Joint Hypermobility Syndrome Present in Secondary Care? The Prevalence in a General Hospital and the Challenges of Classification. Musculoskeletal Care 2016; 15:3-9. [PMID: 27238954 DOI: 10.1002/msc.1147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- May To
- Department of Therapies, Charing Cross Hospital, London, UK
| | - Jane Simmonds
- The hypermobility unit at Hospital of St. John and St Elizabeth, London, UK and the Institute of Child Health, University College London, London, UK
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Vallis A, Wray A, Smith T. Inter- and intra-rater reliabilities of the Beighton Score compared to the Contompasis Score to assess Generalised Joint Hypermobility. ACTA ACUST UNITED AC 2016. [DOI: 10.3109/10582452.2016.1140255] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Amy Vallis
- aPhysiotherapy Department, East Coast Community Healthcare, Lowestoft, Norfolk, VA, USA,
| | - Alison Wray
- bPhysiotherapy Department, Norfolk and Norwich University Hospital, Norwich, Norfolk, VA, USA, and
| | - Toby Smith
- cSchool of Health Sciences, University of East Anglia, Norwich, Norfolk, VA, USA
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Jindal P, Narayan A, Ganesan S, MacDermid JC. Muscle strength differences in healthy young adults with and without generalized joint hypermobility: a cross-sectional study. BMC Sports Sci Med Rehabil 2016; 8:12. [PMID: 27119015 PMCID: PMC4845357 DOI: 10.1186/s13102-016-0037-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 04/13/2016] [Indexed: 01/23/2023]
Abstract
Background Generalized joint hypermobility (GJH), in the absence of symptoms, is a common clinical finding. The joint instability present due to excessive musculoskeletal flexibility in hypermobile joints impairs the external force production during muscle contraction. However, whether GJH is associated with muscle weakness is unclear. This study evaluated differences in upper and lower limb muscle strengths among asymptomatic young adults with and without GJH. Methods One hundred six young adults (53 hypermobile, i.e. 25 male (mean age 22 ± 1.8); 28 female (mean age 21 ± 1.8), and 53 non-hypermobile, i.e. 25 male (mean age 19 ± 1.06); 28 female (mean age 20 ± 1.4) were selected using a cut-off ≥ 4 on Beighton and Horan Joint Mobility Index. Isometric strength of elbow and knee extensors was measured using an isokinetic dynamometer. Independent sample t- tests were done to compare the muscle strengths of hypermobile and non-hypermobile participants. One-way ANCOVA was applied to control the effect of height and body mass on muscle strength. Results Male hypermobile participants had significantly less strength than non-hypermobile males in the right (71.7 Nm, SD = 23.1, vs 97.6 Nm, SD = 47.4, p = 0.006*) and left (74.8 Nm, SD = 24.3, vs 97.7 Nm, SD = 45.5, p = 0.007*) elbow extensors and right knee extensors (188.7 Nm, SD = 83.3, vs 228.3 Nm, SD = 106.7, p = 0.03*). In females, both elbow extensors (right: 51.9 Nm, SD = 16.2 vs 48.8 Nm, SD = 17.8, p = 0.4; left: 48.9 Nm, SD = 17.2, vs 44.7 Nm, SD = 15.1, p = 0.2) and knee extensors (right: 161.3 Nm, SD = 74.9 vs 145.5 Nm, SD = 75.8, p = 0.3; left: 155.2 Nm, SD = 73 vs 124.3 Nm, SD = 69.6, p = 0.07) strength were not statistically different between hypermobile and non-hypermobile participants. Conclusion The findings indicate that male participants with GJH have less isometric muscle strength in both elbow extensors and right knee extensors compared to non-hypermobile male participants. Female hypermobile participants did not show any significant differences in muscle strength compared to non-hypermobile female participants. Electronic supplementary material The online version of this article (doi:10.1186/s13102-016-0037-x) contains supplementary material, which is available to authorized users.
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Bates AV, McGregor AH, Alexander CM. Reliability and minimal detectable change of gait kinematics in people who are hypermobile. Gait Posture 2016; 44:37-42. [PMID: 27004630 DOI: 10.1016/j.gaitpost.2015.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/28/2015] [Accepted: 11/03/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate intra- and inter-session reliability of gait data in hypermobile and normal adults, and from this, determine the minimum detectable change (MDC) through 3D gait analysis (GA) measurement. METHODS Thirteen people with normal flexibility (Beighton score 0.82 ± 1.2) and 14 hypermobile people (Beighton score 5.6 ± 1.6) completed three separate GA sessions. Lower limb joint kinematics were recorded in three planes of motion. Intra- and inter-session variability was calculated and compared using single factor ANOVA. MDC at 95% confidence level was calculated for the hypermobile cohort. RESULTS There was no significant difference between hypermobile and normal flexibility adults in intra- or inter-session variability for any parameters measured. For both groups, mean intra-session variability was under 2.0° for all joints in all three planes. Inter-session variability was greater; sagittal plane joint angles were most reliable, showing less than 3.0° variability for all joints. Frontal plane variability was below 3.5°. Highest variability was seen in internal/external rotation angles, with hip, knee and ankle showing 4.6°, 5.1° and 3.2° variability respectively. These reliability values are reflected in MDC results, with pelvis and sagittal plane joint angles showing the lowest MDCs. CONCLUSIONS In hypermobile people, 3DGA kinematic parameters are repeatable. Hypermobile people's joint laxity does not affect variability of their kinematic gait analysis measures. The results will help guide future clinical trial design; future work should ensure that differences expected to be observed are measurable, and exceed the MDC for a given parameter.
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Affiliation(s)
- Alexander V Bates
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline M Alexander
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Physiotherapy, Imperial College Healthcare NHS Trust, London, UK
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Is HIV Painful? An Epidemiologic Study of the Prevalence and Risk Factors for Pain in HIV-infected Patients. Clin J Pain 2015; 31:813-819. [PMID: 25329144 DOI: 10.1097/ajp.0000000000000162] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the prevalence, impact, and risk factors for pain among a cohort of human immunodeficiency virus (HIV)-infected adults treated with combination antiretroviral therapy if indicated according to current guidelines. METHODS This was a cross-sectional epidemiological observational study. All patients attending 1 HIV-outpatient center in the United Kingdom in a 10-month period were eligible. Patients completed a validated questionnaire enquiring about demographics, HIV factors, and symptoms of pain. RESULTS Of 1050 eligible participants, 859 (82%) completed a questionnaire. The 1-month period prevalence of pain lasting >1 day was 62.8% among whom 63% reported current pain. The prevalence of pain at most anatomic sites was broadly similar to that observed in population studies using the same questionnaires except that we found considerably higher rates of foot/ankle pain. The median duration of pain was 3 years (range, 0 to 51 y) and the median pain score was 5.0 on an 11-point visual analogue score. Over 40% of people in pain had consulted their primary care physician and >20% were taking analgesics daily. Independent risk factors for current pain were older age (P=0.001), time since diagnosis of HIV infection (P=0.001), and receipt of a protease inhibitor-based regimen (P=0.04). DISCUSSION Pain, and notably foot/ankle pain, is common among adults living with prevalent HIV and is associated with substantial morbidity and health care utilization.
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Eccles JA, Owens AP, Mathias CJ, Umeda S, Critchley HD. Neurovisceral phenotypes in the expression of psychiatric symptoms. Front Neurosci 2015; 9:4. [PMID: 25713509 PMCID: PMC4322642 DOI: 10.3389/fnins.2015.00004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/05/2015] [Indexed: 12/01/2022] Open
Abstract
This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brain-body mechanisms underlie individual differences in psychophysiological reactivity that can be important for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in “emotional” brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity during postural change and as recently recognized factors causing vasodilatation (as noted post-prandially, post-exertion and with heat) is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiety.
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Affiliation(s)
- Jessica A Eccles
- Psychiatry, Brighton and Sussex Medical School Brighton, UK ; Sussex Partnership National Health Service Foundation Trust Brighton, UK
| | - Andrew P Owens
- National Hospital Neurology and Neurosurgery, UCL National Health Service Trust London, UK ; Institute of Neurology, University College London London, UK
| | - Christopher J Mathias
- National Hospital Neurology and Neurosurgery, UCL National Health Service Trust London, UK ; Institute of Neurology, University College London London, UK
| | - Satoshi Umeda
- National Hospital Neurology and Neurosurgery, UCL National Health Service Trust London, UK ; Department of Psychology, Keio University Tokyo, Japan
| | - Hugo D Critchley
- Psychiatry, Brighton and Sussex Medical School Brighton, UK ; Sussex Partnership National Health Service Foundation Trust Brighton, UK ; Sackler Centre for Consciousness Science, University of Sussex Falmer, UK
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Luder G, Schmid S, Stettler M, Mueller Mebes C, Stutz U, Ziswiler HR, Radlinger L. Stair climbing – An insight and comparison between women with and without joint hypermobility: A descriptive study. J Electromyogr Kinesiol 2015; 25:161-7. [DOI: 10.1016/j.jelekin.2014.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022] Open
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Jones LE, O'Shaughnessy DF. The Pain and Movement Reasoning Model: Introduction to a simple tool for integrated pain assessment. ACTA ACUST UNITED AC 2014; 19:270-6. [DOI: 10.1016/j.math.2014.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/20/2014] [Accepted: 01/29/2014] [Indexed: 02/08/2023]
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Schmid S, Luder G, Mueller Mebes C, Stettler M, Stutz U, Ziswiler HR, Radlinger L. Neuromechanical gait adaptations in women with joint hypermobility--an exploratory study. Clin Biomech (Bristol, Avon) 2014; 28:1020-5. [PMID: 24120181 DOI: 10.1016/j.clinbiomech.2013.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/17/2013] [Accepted: 09/18/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Joint hypermobility is known to be associated with joint and muscle pain, joint instability and osteoarthritis. Previous work suggested that those individuals present an altered neuromuscular behavior during activities such as level walking. Therefore, the aim of this study was to explore the differences in ground reaction forces, temporal parameters and muscle activation patterns during gait between normomobile and hypermobile women, including symptomatic and asymptomatic hypermobile individuals. METHODS A total of 195 women were included in this cross-sectional study, including 67 normomobile (mean 24.8 [SD 5.4] years) and 128 hypermobile (mean 25.8 [SD 5.4] years), of which 56 were further classified as symptomatic and 47 as asymptomatic. The remaining 25 subjects could not be further classified. Ground reaction forces and muscle activation from six leg muscles were measured while the subjects walked at a self-selected speed on an instrumented walkway. Temporal parameters were derived from ground reaction forces and a foot accelerometer. The normomobile and hypermobile groups were compared using independent samples t-tests, whereas the normomobile, symptomatic and asymptomatic hypermobile groups were compared using one-way ANOVAs with Tukey post-hoc tests (significance level=0.05). FINDINGS Swing phase duration was higher among hypermobile (P=0.005) and symptomatic hypermobile (P=0.018) compared to normomobile women. The vastus medialis (P=0.049) and lateralis (P=0.030) and medial gastrocnemius (P=0.011) muscles showed higher mean activation levels during stance in the hypermobile compared to the normomobile group. INTERPRETATION Hypermobile women might alter their gait pattern in order to stabilize their knee joint.
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Affiliation(s)
- Stefan Schmid
- Bern University of Applied Sciences, Health Division, Discipline of Physiotherapy, Bern, Switzerland.
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Hakim AJ, Grahame R. Recognizing the scale of joint hypermobility burden: comment on the article by Mulvey et al. Arthritis Care Res (Hoboken) 2014; 66:496. [PMID: 24591418 DOI: 10.1002/acr.22221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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