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Akaltun MS, Koçyiğit BF. Assessment of foot posture and related factors in patients with knee osteoarthritis. Arch Rheumatol 2021; 36:267-273. [PMID: 34527932 PMCID: PMC8418765 DOI: 10.46497/archrheumatol.2021.8354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/12/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives The aim of this study was to compare foot posture between patient and control groups, and to identify factors associated with foot posture abnormality in knee osteoarthritis (OA). Patients and methods This case-control study included a total of 115 patients (26 males, 89 females; mean age: 54.4±9.3 years; range, 29 to 73 years) with OA and 77 healthy controls (20 males, 57 females; mean age: 52.1±8.1 years; range, 32 to 69 years) between May 2019 and July 2019. The participants were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), and the Beighton criteria. Radiological assessments were performed using the Kellgren-Lawrence grading, condylar plateau angle, and medial tibiofemoral joint width. The Foot Posture Index-6 (FPI-6) was used for foot posture analysis and three groups were formed as supinated, neutral, and pronated postures. Results Foot posture was significantly different between the patient and control groups (p<0.05). Of the patients with knee OA, significant differences were found in the VAS, WOMAC-pain, WOMAC-physical function, and WOMAC-total (p<0.05) among the foot postures. No significant difference was found among the foot posture groups in terms of the radiological parameters and WOMAC-stiffness (p>0.05). Hypermobility and WOMAC-total scores were significantly associated with foot posture abnormality (p<0.05). Conclusion Joint hypermobility and foot posture are the factors which may influence the clinical characteristics of knee OA. Foot posture and joint hypermobility should be taken into consideration during the examination and management of patients with knee OA.
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Affiliation(s)
- Mazlum Serdar Akaltun
- Department of Physical Medicine and Rehabilitation, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Burhan Fatih Koçyiğit
- Department of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü Imam University, Faculty of Medicine, Kahramanmaraş, Turkey
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Gürer G, Bozbas GT, Tuncer T, Unubol AI, Ucar UG, Memetoglu OI. Frequency of joint hypermobility in Turkish patients with knee osteoarthritis: a cross sectional multicenter study. Int J Rheum Dis 2016; 21:1787-1792. [DOI: 10.1111/1756-185x.12883] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gülcan Gürer
- Division of Rheumatology; Department of Physical Medicine and Rehabilitation; Adnan Menderes University School of Medicine; Aydin Turkey
| | - Gulnur Tasci Bozbas
- Division of Rheumatology; Department of Physical Medicine and Rehabilitation; Adnan Menderes University School of Medicine; Aydin Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation; Akdeniz University School of Medicine; Antalya Turkey
| | - Ayse Iyiyapici Unubol
- Division of Rheumatology; Department of Physical Medicine and Rehabilitation; Adnan Menderes University School of Medicine; Aydin Turkey
| | - Ulku Gurbuz Ucar
- Department of Physical Medicine and Rehabilitation; Akdeniz University School of Medicine; Antalya Turkey
| | - Ozge Illeez Memetoglu
- Department of Physical Medicine and Rehabilitation; Akdeniz University School of Medicine; Antalya Turkey
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Abstract
Like athletes, musicians are vulnerable to musculoskeletal injuries that can be career ending or have a severe negative financial impact. All ages are affected, with a peak incidence in the third and fourth decades. Women are slightly more likely to be affected than men. It is incumbent upon orthopaedic surgeons to be able to complete a thorough physical assessment, be aware of the risk factors associated with musculoskeletal symptoms in musicians, and have a detailed knowledge of the specific syndromes they suffer and their appropriate treatment. In this paper we review the common hand injuries that afflict musicians and discuss their treatment. Cite this article: Bone Joint J 2013;95-B:146–50.
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Affiliation(s)
- S. Sheibani-Rad
- McLaren Regional Medical Center/Michigan
State University, 401 South Ballenger Highway, Flint, Michigan
48532, USA
| | - S. Wolfe
- Hospital for Special Surgery, 535
East 70th Street, New York, New York
10021, USA
| | - J. Jupiter
- Massachusetts General Hospital, 15
Parkman Street, Boston, Massachusetts
02114, USA
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Vieira RB, Bertolini FM, Vieira TC, Aguiar RM, Pinheiro GB, Lasmar RCP. IINCIDENCE OF ANKLE SPRAINS IN SOCCER PLAYERS WITH JOINT HYPERMOBILITY SYNDROME. REVISTA BRASILEIRA DE ORTOPEDIA (ENGLISH EDITION) 2012; 47:710-3. [PMID: 27047888 PMCID: PMC4799473 DOI: 10.1016/s2255-4971(15)30026-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 05/03/2012] [Indexed: 11/03/2022]
Abstract
Objective: Eighty-three soccer players aged between 14 and 19 years, in the basic category of a professional soccer club in the city of Belo Horizonte, were followed up during the 2009 season. Methods: A prospective observational cohort study was conducted, in which these soccer players were divided randomly into two groups. The first consisted of individuals with joint hypermobility syndrome (JHS), totaling 22 players, and the second was a control group with 61 players without this syndrome, determined through a physical examinati. Results: Both groups were studied with regard to incidence of ankle sprains. At the end of this period, the data were compiled and statistical analysis was performed. A total of 43 cases of ankle injury due to sprains were recorded, of which nine episodes were in players with JHS, thus making p = 0.106. The significance level was 5%. Conclusion: We were able to conclude that in our study there was insufficient evidence to assert that there is an association with increased incidence of ankle sprains among patients with JHS.
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Clinch J, Deere K, Sayers A, Palmer S, Riddoch C, Tobias JH, Clark EM. Epidemiology of generalized joint laxity (hypermobility) in fourteen-year-old children from the UK: a population-based evaluation. ACTA ACUST UNITED AC 2011; 63:2819-27. [PMID: 21547894 PMCID: PMC3164233 DOI: 10.1002/art.30435] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective Although diagnostic criteria for generalized ligamentous laxity (hypermobility) in children are widely used, their validity may be limited, due to the lack of robust descriptive epidemiologic data on this condition. The present study was undertaken to describe the point prevalence and pattern of hypermobility in 14-year-old children from a population-based cohort. Methods We performed a cross-sectional analysis using the Avon Longitudinal Study of Parents and Children, a large population-based birth cohort. Hypermobility among children in the cohort (mean age 13.8 years) was measured using the Beighton scoring system. Objective measures of physical activity were ascertained by accelerometry. Data on other variables, including puberty and socioeconomic status, were collected. Simple prevalence rates were calculated. Chi-square tests and logistic regression analyses were used to assess associations of specific variables with hypermobility. Results Among the 6,022 children evaluated, the prevalence of hypermobility (defined as a Beighton score of ≥4 [i.e., ≥4 joints affected]) in girls and boys age 13.8 years was 27.5% and 10.6%, respectively. Forty-five percent of girls and 29% of boys had hypermobile fingers. There was a suggestion of a positive association between hypermobility in girls and variables including physical activity, body mass index, and maternal education. No associations were seen in boys. Conclusion We have shown that the prevalence of hypermobility in UK children is high, possibly suggesting that the Beighton score cutoff of ≥4 is too low or that this scoring is not appropriate for use in subjects whose musculoskeletal system is still developing. These results provide a platform to evaluate the relationships between the Beighton criteria and key clinical features (including pain), thereby testing the clinical validity of this scoring system in the pediatric population.
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Affiliation(s)
- Jacqui Clinch
- Bristol Royal Hospital for Children, University of Bristol, Bristol, UK.
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Ercolani M, Galvani M, Franchini C, Baracchini F, Chattat R. Benign Joint Hypermobility Syndrome: Psychological Features and Psychopathological Symptoms in a Sample Pain-Free at Evaluation. Percept Mot Skills 2008; 107:246-56. [DOI: 10.2466/pms.107.1.246-256] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
30 subjects with BJHS (Hypermobile) ( M age = 32.3 yr., SD = 10.4) and two control groups, 25 healthy subjects (Healthy) ( M age = 33.9 yr., SD = 93) and 30 fibromyalgic patients (Fibromyalgic) ( M age = 32.2 yr., SD = 9.4), were given the Symptom Checklist-90-R, the Illness Behavior Questionnaire, the Female Functional Symptoms Frequency (FFF) and the Male Functional Symptoms Frequency (MFF), derived from the DSM-III–R, evaluating functional somatic disturbances and their intensity, and the Symptom Questionnaire. The mean scores for the Hypermobile group showed significant psychological distress and increased frequency and intensity of somatic symptoms. Scores on Anxiety and Somatic Symptoms, General Hypochondriasis, Disease Conviction, Affective Disturbance, Denial, and Irritability were significantly higher in the Hypermobile than in the Healthy group. Elevated scores were found for the Fibromyalgic group on the Illness Behavior Questionnaire subscales for Psychological vs Somatic Focus, Disease Affirmation, and Discriminating Factors when compared with the Hypermobile group. Considerable emotional symptoms were detected which should not be underestimated by physicians when establishing an integrated biopsychosocial therapy.
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ERCOLANI MAURO. BENIGN JOINT HYPERMOBILITY SYNDROME: PSYCHOLOGICAL FEATURES AND PSYCHOPATHOLOGICAL SYMPTOMS IN A SAMPLE PAIN-FREE AT EVALUATION. Percept Mot Skills 2008. [DOI: 10.2466/pms.107.5.246-256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kraus VB, Li YJ, Martin ER, Jordan JM, Renner JB, Doherty M, Wilson AG, Moskowitz R, Hochberg M, Loeser R, Hooper M, Sundseth S. Articular hypermobility is a protective factor for hand osteoarthritis. ACTA ACUST UNITED AC 2004; 50:2178-83. [PMID: 15248215 DOI: 10.1002/art.20354] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Very few studies have evaluated the association of articular hypermobility and radiographic osteoarthritis (OA) in humans. We assessed hypermobility and its relationship to radiographic hand OA in a family-based study. METHODS A total of 1,043 individuals were enrolled in the multicenter Genetics of Generalized Osteoarthritis study, in which families were required to have 2 siblings with radiographic OA involving >/=3 joints (distributed bilaterally) of the distal interphalangeal (DIP), proximal interphalangeal (PIP), or carpometacarpal (CMC) joint groups, and OA in at least one DIP joint. Radiographic OA was defined as a score of >/=2 on the Kellgren/Lawrence scale in one or more joints within the group. The Beighton criteria for assessment of hypermobility were recorded on a 0-9-point scale. Hypermobility was defined as a Beighton score of >/=4, a threshold generally used to establish a clinical diagnosis of joint laxity. A threshold of >/=2 was also evaluated to assess lesser degrees of hypermobility. The Beighton score for the present was calculated based on clinical examination, and that for the past was based on recall of childhood hypermobility in the first 2 decades of life. The association of hypermobility and radiographic OA of the PIP, CMC, and metacarpophalangeal joints was evaluated in all participants and in men and women separately. Multiple logistic regression was used to examine the relationship of hypermobility with radiographic OA in each joint group, after adjusting for age and sex. The association of hypermobility and DIP OA was not evaluated, because evidence of DIP OA was required for study inclusion. RESULTS Using a threshold Beighton score of 4, 3.7% of individuals were classified as hypermobile based on the present examination, and 7.4% were classified as hypermobile based on the past assessment. A significant negative association between present hypermobility and age was observed. In persons with hypermobility, the odds of OA in PIP joints was lower (for present, odds ratio [OR] 0.34, 95% confidence interval [95% CI] 0.16-0.71; for past, OR 0.43, 95% CI 0.24-0.78). Similar results were obtained using a threshold Beighton score of 2. The lower odds of PIP OA with hypermobility were significant after adjusting for sex and age (for present, OR 0.44, 95% CI 0.20-0.94; for past, OR 0.48, 95% CI 0.26-0.87). CONCLUSION This study demonstrated a joint-protective effect of hypermobility for radiographic OA of PIP joints. In contrast to previous studies showing an association of hypermobility and CMC OA, in this cohort there was no evidence for increased odds of OA in any joint group of the hand in association with articular hypermobility.
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Affiliation(s)
- V B Kraus
- Duke University Medical Center, Durham, North Carolina 27710, USA.
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Verhoeven JJ, Tuinman M, Van Dongen PW. Joint hypermobility in African non-pregnant nulliparous women. Eur J Obstet Gynecol Reprod Biol 1999; 82:69-72. [PMID: 10192488 DOI: 10.1016/s0301-2115(98)00182-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the prevalence of joint hypermobility in non-pregnant nulliparous women and the influences of age and Quetelet-index in a rural, female population in Tanzania. STUDY DESIGN A cross-sectional study. Joint mobility was measured according to the scoring systems of Beighton and Biro. RESULTS According to the Beighton criteria with a score of 0 to 9 points, 50.5% of 705 non-pregnant nulliparous women scored 3, while 30.8% scored > or =4 and 18.6% > or =5. There were no correlations between hypermobility and age or Quetelet-index. The prevalence of hypermobility at the dominant body side was significantly lower (19.2%) than at the non-dominant side (23.4%) (p<0.001). CONCLUSION This study confirms that there are ethnic differences in the prevalence of hypermobility. The prevalence of hypermobility in Tanzanian non-pregnant nulliparous women is about 1.5-times higher as compared to Dutch non-pregnant nulliparous women. Prevalence of hypermobility was higher at the non-dominant body side. The most predictive test for the diagnosis of hypermobility was the hyperextension of the elbows >10 degrees.
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Rikken-Bultman DG, Wellink L, van Dongen PW. Hypermobility in two Dutch school populations. Eur J Obstet Gynecol Reprod Biol 1997; 73:189-92. [PMID: 9228503 DOI: 10.1016/s0301-2115(97)02745-0] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the presence of hypermobility and differences between females and males in a Dutch population. STUDY DESIGN Joint mobility was measured in a primary and a secondary school population. Beighton and Biro measurements were used. The data were evaluated statistically. RESULTS Using the Beighton score, 15.5% of group I (n = 252; 4-13 years) and 13.4% of group II (n = 658; 12-17 years) were hypermobile. Hypermobility was found more in females than in males, the difference being significant in the older group. Overall, hypermobility did not significantly diminish with ageing, although the individual joints did not show a significant decrease in mobility with ageing. Hypermobility was significantly more pronounced at the non-dominant body side in both groups. The Quetelet-index did not show a significant relation to hypermobility. CONCLUSION Hypermobility was found more in females than in males, with a trend of decrease of hypermobility with ageing. The non-dominant body side proved to be more hypermobile and the Quetelet-index did not show a relation to hypermobility. Beighton's measurements proved best, since Biro considers the two body sides being equal.
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Affiliation(s)
- D G Rikken-Bultman
- Department of Obstetrics and Gynaecology, University Hospital Nijmegen, The Netherlands
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Bejjani FJ, Kaye GM, Benham M. Musculoskeletal and neuromuscular conditions of instrumental musicians. Arch Phys Med Rehabil 1996; 77:406-13. [PMID: 8607768 DOI: 10.1016/s0003-9993(96)90093-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Performing Arts Medicine is a broad field that includes the study of medical conditions and injuries incurred by dancers, instrumental musicians, and vocalists. This article summarizes the most relevant literature of approximately the past 10 years concerning the musculoskeletal and neuromuscular conditions of musicians. A literature search was done for relevant articles in English by physicians or scientists. Some older, but fundamental, articles are included; incidental case reports were excluded to the extent possible. Included were articles on incidence, prevalence, pathophysiology, diagnosis, treatment, and biomechanical studies in musicians. Although nearly all of these conditions are the same ones seen in the general work force, it is clear that their occurrence patterns in the professional musician are unique, as is their impact on the life and livelihood of the patient. The content of the Arts Medicine literature does not permit a truly critical review. Research in the last 10 years appears not to have been done in a true blinded, random case-controlled fashion. Many authors support their statements with only their respective clinical experiences. The research cited here includes 58 series, 9 case studies, 5 surveys, 2 pre/post intervention studies, and 1 double-blind crossover clinical trial.
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Affiliation(s)
- F J Bejjani
- Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Newark, 07103, USA
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Larsson LG, Mudholkar GS, Baum J, Srivastava DK. Benefits and liabilities of hypermobility in the back pain disorders of industrial workers. J Intern Med 1995; 238:461-7. [PMID: 7595186 DOI: 10.1111/j.1365-2796.1995.tb01224.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Back pain disorders, sometimes called 'the nemesis of medicine and the albatross of industry', are ubiquitous, but have stubbornly defied diagnosis and treatment. Hypermobility syndrome, which is also very common, has been called 'an enigma of human physiology'. Both conditions have attracted wide attention and interest only recently. In an earlier study, we considered the benefits and liabilities of joint hypermobility by studying 660 musicians in the USA. In a parallel manner, the present study analysed the back pain disorders of 606 workers in a Swedish high-technology industrial plant in the context of spinal hypermobility. SUBJECTS AND METHODS The 606 industrial workers were examined for spinal hypermobility using a standard protocol, and interviewed for work-related body-posture requirements and the low back, shoulder and neck pain disorders experienced by them. The data were analysed for associations between hypermobility and physical complaints as a whole, and by taking into account gender and body-postures at work. RESULTS Twenty-six per cent (37) of 144 workers with hypermobility but only 14% (64) of 453 without hypermobility experienced back pain (P < 0.002). Among the 326 workers with sitting or standing jobs, 40% (29) of 71 with hypermobility had back pain, whereas only 12% (30) of the 255 without hypermobility experienced back pain (P < 0.001). The corresponding numbers with back pain for 235 in jobs with changing body-postures were 4.5% (3) of 66 with hypermobility and 14% (14) of 169 without hypermobility (P = 0.04). CONCLUSIONS Hypermobility of the spine is an asset if the work requires change of body-posture, but a liability for those in a standing or sitting assignment. It reinforces a similar hypothesis proposed by Larsson et al.
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Affiliation(s)
- L G Larsson
- Hospital for Rheumatic Diseases, Ostersund, Sweden
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