Core Muscle Endurance, Upper Extremity Muscle Strength, Grip Strength, and Hand-Eye Coordination in Young Adults with Generalized Joint Hypermobility

Abstract

Aim: Generalized joint hypermobility (GJH) is recognized as one of the risk factors for musculoskeletal impairments. This study aimed to evaluate core muscle endurance, upper extremity muscle strength, grip strength, and hand-eye coordination in young adults with GJH. Method: This is a cross-sectional and observational study. Twenty-seven young adults with GJH, aged 17–26 years, and an age-matched group of 27 young adults without GJH were recruited in the study. All participants performed core muscle endurance tests, upper extremity muscle strength test, hand-grip and pinch-grip strength tests, and the alternate hand-wall toss test. Results: Considering the descriptive features, no statistically significant differences were identified between the groups (p>0.05). The mean Beighton score was 5.26±2.38 in the GJH group, which indicates joint hypermobility (p<0.001). While a significant difference was found between the groups for the trunk flexion test (p = 0.002), right side plank test (p=0.013), and left side plank test (p=0.039) in the tests of core muscle endurance, there was no significant difference in the trunk extension test (p=0.532), horizontal plank test (p=0.190), and alternate hand wall toss test (p=0.127). Conclusion: The young adults in the present study who had been grouped as having GJH (Beighton score≥4) showed a decline in upper extremity strength, grip strength, and core muscle endurance. This study, in combination with the findings of the literature, suggests that a comprehensive screening program for the early recognition of GJH is required to prevent musculoskeletal problems.

Keywords

• Coordination
• hypermobility
• muscle strength
• young adult

Generalize Eklem Hipermobilitesi Olan Genç Erişkinlerde Core Kas Dayanıklılığı, Üst Ekstremite Kas Kuvveti, Kavrama Kuvveti ve El-Göz Koordinasyonu

Abstract

Amaç: Generalize eklem hipermobilitesi (GEH) kas-iskelet sistemi bozuklukları için risk faktörlerinden biri olarak kabul edilmektedir. Bu çalışmada GEH'li genç erişkinlerde core kas dayanıklılığı, üst ekstremite kas kuvveti, kavrama kuvveti ve el-göz koordinasyonunun değerlendirilmesi amaçlandı. Yöntem: Bu kesitsel ve gözlemsel bir çalışmadır. Çalışmada yaşları 17-26 arasında değişen GEH'li 27 genç erişkin grup ve GEH olmayan 27 genç erişkin grup karşılaştırıldı. Tüm katılımcılara core kas dayanıklılık testleri, üst ekstremite kas kuvveti testi, el kavrama ve parmak kavrama kuvveti testleri ve alternatif el-duvar fırlatma testi uygulandı Bulgular: Tanımlayıcı özellikler göz önüne alındığında, gruplar arasında istatistiksel olarak anlamlı bir fark tespit edilmedi (p>0,05). Ortalama Beighton skoru GEH grubunda 5,26±2,38 olup eklem hipermobilitesini göstermektedir (p<0,001). Core kas enduransı testlerinde gövde fleksiyon testi (p=0,002), sağ yan köprü testi (p=0,013) ve sol yan köprü testi (p=0,039) için gruplar arasında anlamlı fark bulunurken, gövde ekstansiyon testi (p=0,532), horizantal köprü testi (p=0,190) ve alternatif el duvar fırlatma testinde (p=0,127) anlamlı fark bulunmadı. Sonuç: Bu çalışmada GEH tespit edilen (Beighton skoru≥4) genç erişkinlerin üst ekstremite ve kavrama kuvveti ile core kas dayanıklılığında azalma görüldü. Çalışma, literatürdeki bulgularla birlikte, kas-iskelet sistemi sorunlarının önlenmesi için GEH'in erken tespit edilmesine yönelik kapsamlı bir tarama programının gerekli olduğunu düşündürmektedir.

Keywords

• Genç erişkin
• hipermobilite
• kas kuvveti
• koordinasyon

References

1. 1. Beighton PH, Grahame R, Bird H. Hypermobility of Joints. Fourth Editions. United Kingdom: Springer Science & Business Media; 2011.
2. 2. Hakim AJ, Cherkas LF, Grahame R, et al. The genetic epidemiology of joint hypermobility: a population study of female twins. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 2004;50(8):2640-2644.
3. 3. Hakim AJ, Grahame R. Joint hypermobility. Best Practice & Research Clinical Rheumatology. 2003;17(6):989-1004.
4. 4. Grahame R, Bird H, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). The Journal of Rheumatology. 2000;27(7):1777-1779.
5. 5. Chahal J, Leiter J, McKee MD, Whelan DB. Generalized ligamentous laxity as a predisposing factor for primary traumatic anterior shoulder dislocation. Journal of Shoulder and Elbow Surgery. 2010;19(8):1238-1242.
6. 6. Pacey V, Nicholson LL, Adams RD, et al. Generalized joint hypermobility and risk of lower limb joint injury during sport: A systematic review with meta-analysis. The American Journal of Sports Medicine. 2010;38(7):1487-1497.
7. 7. Tingle A, Bennett O, Wallis A, Palmer S. The links between generalized joint laxity and the incidence, prevalence and severity of limb injuries related to physical exercise: A systematic literature review. Physical Therapy Reviews. 2018;23(4-5):259-272.
8. 8. Smith R, Damodaran A, Swaminathan S, et al. Hypermobility and sports injuries in junior netball players. British Journal of Sports Medicine. 2005;39(9):628-631.

9. 9. Scheper MC, Juul-Kristensen B, Rombaut L, et al. Disability in adolescents and adults diagnosed with hypermobility-related disorders: A meta-analysis. Archives of Physical Medicine and Rehabilitation. 2016;97(12):2174-2187.
10. 10. Putra AL. The Contribution of arm muscle strength and coordination of hand eye towards chest pass skills in self development activities of basketball. Atlantis Press. 2020:427-430.
11. 11. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39(2):175-191.
12. 12. 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 Science, Medicine and Rehabilitation. 2016;8(1):1-9.
13. 13. Beighton P, Solomon L, Soskolne C. Articular mobility in an African population. Annals of the Rheumatic Diseases. 1973;32(5):413.
14. 14. Wells KF, Dillon EK. The sit and reach - a test of back and leg flexibility. Research Quarterly American Association for Health, Physical Education and Recreation. 1952;23(1):115-118.
15. 15. McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Archives of Physical Medicine and Rehabilitation. 1999;80(8):941-944.
16. 16. Ito T, Shirado O, Suzuki H, et al. Lumbar trunk muscle endurance testing: An inexpensive alternative to a machine for evaluation. Archives of Physical Medicine and Rehabilitation. 1996;77(1):75-79.
17. 17. McGill S. Ultimate Back Fitness and Performance. Third Edition. Canada: Orthopedic Physical Therapy Product Canada; 2006.
18. 18. Douma R. Clinical Muscle Strength Measurements: Reference Values and Reliability. Holland: University of Groningen Press; 2021.
19. 19. Schrama PP, Stenneberg MS, Lucas C, Van Trijffel E. Intraexaminer reliability of hand-held dynamometry in the upper extremity: A systematic review. Archives of Physical Medicine and Rehabilitation. 2014;95(12):2444-2469.
20. 20. Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Physical Therapy. 1996;76(3):248-259.
21. 21. Bellace JV, Healy D, Besser MP, et al. Validity of the Dexter Evaluation System's Jamar dynamometer attachment for assessment of hand grip strength in a normal population. Journal of Hand Therapy. 2000;13(1):46-51.
22. 22. Ong HL, Abdin E, Chua BY, et al. Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors. BMC Geriatrics. 2017;17(1):1-11.
23. 23. Lindstrom-Hazel D, Kratt A, Bix L. Interrater reliability of students using hand and pinch dynamometers. The American Journal of Occupational Therapy. 2009;63(2):193-197.
24. 24. McQuiddy VA, Scheerer CR, Lavalley R, et al. Normative values for grip and pinch strength for 6-to 19-year-olds. Archives of Physical Medicine and Rehabilitation. 2015;96(9):1627-1633.
25. 25. Cho EH, Yun HJ, So WY. The validity of alternative hand wall toss tests in Korean children. Journal of Men’s Health. 2020;16(1):10-18.
26. 26. Beashel P, Taylor J. Fitness for Health and performance. The World of Sport Examined. 1997;55.
27. 27. Wood R. Alternate hand wall toss test. Topend Sports. https://www.topendsports.com/testing/tests/wall-catch.htm. Published April 2005. Accessed date: 03.04.2024.
28. 28. Russek LN, Errico DM. Prevalence, injury rate and symptom frequency in generalized joint laxity and joint hypermobility syndrome in a “healthy” college population. Clinical Rheumatology. 2016;35:1029-1039.
29. 29. Scheper M, De Vries J, Beelen A, et al. Generalized joint hypermobility, muscle strength and physical function in healthy adolescents and young adults. Current Rheumatology Reviews. 2014;10(2):117-125.
30. 30. Junge T, Henriksen P, Hansen S, et al. Generalised joint hypermobility and knee joint hypermobility: prevalence, knee joint symptoms and health‐related quality of life in a Danish adult population. International Journal of Rheumatic Diseases. 2019;22(2):288-296.
31. 31. Juul-Kristensen B, Østengaard L, Hansen S, et al. Generalised joint hypermobility and shoulder joint hypermobility, risk of upper body musculoskeletal symptoms and reduced quality of life in the general population. BMC Musculoskeletal Disorders. 2017;18(1):1-9.
32. 32. Al‐Jarallah K, Shehab D, Al‐Jaser MT, et al. Prevalence of joint hypermobility in Kuwait. International Journal of Rheumatic Diseases. 2017;20(8):935-940.
33. 33. Pountain G. Musculoskeletal pain in Omanis, and the relationship to joint mobility and body mass index. Rheumatology. 1992;31(2):81-85.
34. 34. Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T. Joint mobility among university students in Iraq. Rheumatology. 1985;24(4):326-331.
35. 35. Akkaya KU, Burak M, Erturan S, et al. An investigation of body awareness, fatigue, physical fitness, and musculoskeletal problems in young adults with hypermobility spectrum disorder. Musculoskeletal Science and Practice. 2022;62:102642.
36. 36. Czaprowski D, Kędra A, Pawłowska P, et al. 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;10(3):e0121360.
37. 37. Ewertowska P, Trzaskoma Z, Sitarski D, et al. Muscle strength, muscle power and body composition in college-aged young women and men with Generalized Joint Hypermobility. Plos one. 2020;15(7):e0236266.
38. 38. Geiser C, Kim H, Kipp K. Individuals with generalized joint hypermobility demonstrate similar lower extremity muscle forces during a dynamic cutting task. ISBS Proceedings Archive. 2020;38(1):412.
39. 39. Chaiparinya P, Gaogasigam C. Prevalence, frontal plane knee alignment, and lower limb joint pain and injury in generalized joint hypermobility in Thai physical therapy students. Reumatologia/Rheumatology. 2022;60(2):116-124.
40. 40. Zsidai B, Piussi R, Thomeé R, et al. Generalized joint hypermobility leads to an 8-fold increase in the odds of sustaining a second ACL injury within 24 months of return to sport after ACL reconstruction. Orthopaedic Journal of Sports Medicine. 2023;11(3_suppl2):2325967123S00014.
41. 41. Song J, Kang C, Jeon JH, Ham CU. Evaluation of the anterior talofibular ligament by stress ultrasound for assessing generalized joint hypermobility. Foot & Ankle Orthopaedics. 2020;5(4):2473011420S00453.
42. 42. Turner EH, Markhardt BK, Cotter EJ, et al. Patients with generalized joint hypermobility have thinner superior hip capsules and greater hip internal rotation on physical examination. Arthroscopy, Sports Medicine, and Rehabilitation. 2022;4(4):e1417-e1427.
43. 43. Liaghat B, Juul-Kristensen B, Frydendal T, et al. Competitive swimmers with hypermobility have strength and fatigue deficits in shoulder medial rotation. Journal of Electromyography and Kinesiology. 2018;39:1-7.
44. 44. Massy-Westropp C, Massy-Westropp N, Wechalekar H. Normative values for pinch strength relationship with joint hypermobility as measured with the beighton criteria. Journal of Hand Surgery Global Online. 2023;5(3):272-276.
45. 45. Mathiowetz V, Kashman N, Volland G, et al. Grip and pinch strength: normative data for adults. Archives of Physical Medicine and Rehabilitation. 1985;66(2):69-74.
46. 46. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Journal of Spinal Disorders. 1992;5:383-383.
47. 47. Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise principles. Current Sports Medicine Reports. 2008;7(1):39-44.
48. 48. Bergmark A. Stability of the lumbar spine: A study in mechanical engineering. Acta Orthopaedica Scandinavica. 1989;60(sup230):1-54.
49. 49. Varol BK, Şırayder U, Sandal M, Tuncer D. The effect of generalized joint hypermobility on functional capacity, pulmonary function, respiratory muscle strength, and chest expansion in healthy young adults. Journal of Health Sciences and Medicine. 2023;6(2):300-306.
50. 50. Booshanam DS, Cherian B, Joseph CPA, et al. Evaluation of posture and pain in persons with benign joint hypermobility syndrome. Rheumatology International. 2011;31(12):1561-1565.
51. 51. Lamari N, Beighton P. Mechanical consequences of joint hypermobility. Hypermobility in Medical Practice. Springer; 2023:63-71.
52. 52. Telford RD, Cunningham RB, Telford RM, et al. Benefits of early development of eye–hand coordination: Evidence from the LOOK longitudinal study. Scandinavian Journal of Medicine & Science in Sports. 2013;23(5):e263-e269.
53. 53. Reddy A, Arunachalam R, Anitha A. Correlation between core muscle strength and hand-eye coordination in non athletes. International Journal of Physiotherapy. 2017:291-295.
54. 54. Tanineh W, Halaweh H. Cardiorespiratory fitness, motor coordination, and academic achievement in school students (11-13 years). Global Pediatric Health. 2023;10:2333794X231207311.