The hypermobility spectrum in rugby union players, netballers and dancers: implications for injury and performance

Ross Armstrong

Abstract


Objectives: Hypermobility has been associated with injury and performance and a new hypermobility framework has been introduced. This study aimed to report the prevalence of localised joint hypermobility, generalised joint hypermobility (GJH), peripheral joint hypermobility and hypermobility Ehlers-Danlos type in female rugby players, male rugby players, female netball players, female dancers, male and female controls.
Methods: This study determined joint hypermobility via the Beighton score and the associated criteria of the hypermobility spectrum in 378 participants.
Results: Localised joint hypermobility ranged from 61.11% (netballers), 57.33% (female rugby), 48.15% (male controls), 46.30% (male rugby), 38.33% (female controls) to 28.57% (female dancers). Significant differences existed for Beighton scores (p<0.001) between female dancers and all other cohorts, female rugby and male controls (p=0.005), male rugby and netball (p=0.001), netball and male controls (p=0.001) and female controls and male controls (p=0.021). Prevalence of GJH ranged from 69.84% (female dancers), 25% (netball), 21.67% (female controls), 18.67% (female rugby), 3.70% (male rugby) to 1.85% (male controls). In participants with GJH, dancers had the highest prevalence of pain and dislocation/subluxation. Significant differences existed between dancers and all other groups for hypermobility Ehlers-Danlos type criteria (p<0.001). Five participants met the criteria for diagnosis of hypermobility Ehlers-Danlos type. Male rugby players had the highest prevalence of peripheral joint hypermobility (29.63%).
Conclusion: Significant findings between dance and other cohorts may highlight a potential performance adaptation. Significant findings between control groups for the Beighton score may indicate a gender effect. There is a need to consider these factors in relation to performance and injury.

Keywords


Beighton score; general joint hypermobility; hypermobility Ehlers-Danlos type; peripheral joint hypermobility; female dancers

Full Text:

PDF

References


Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions Am J Med Genet.2017;175C: 148-157.

Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis.1973;32:413-18.

Remvig L, Jensen DV, Ward RC. Are diagnostic criteria for general joint hypermobility and benign joint hypermobility based on reproducible and valid tests? A review of the literature. J Rheumatol.2007;34:798-803.

Remvig L, Flycht L, Christensen KB, Juul-Kristensen B. Lack of consensus on tests and criteria for generalised joint hypermobility, Ehlers-Danlos syndrome: hypermobile type and joint hypermobility syndrome. Am J Med Genet A.2014; 164a:591-596.

Simpson MR. Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management. J Am Osteopath Assoc.2006;106:531-536.

Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rhuematol.2000;27:1777-1779.

Hakim A, Grahame R. Joint hypermobility. Best Pract Res Clin Rheumatol.2003;17:989-1004.

Scheper MC, de Vries JE, de Vos R, Verbunt J, Nollet F, Engelbert RHH. Generalised joint hypermobility in professional dancers: a sign of talent or vulnerability? Rheumatology 2013;52:651-658.

Tinkle BT, Bird HA, Grahame R, Lavellee M, Levy HP, Sillence D. The lack of clinical distinction between the hypermobility type of Ehlers-Danlos syndrome and the joint hypermobility syndrome (a.k.a. hypermobility syndrome). Am J Med Genet.2009;Part A 149a:2368-2370.

Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J et al. The 2017 International Classification of the Ehlers-Danlos syndromes. Am J Med Genet Part C Semin Med Genet.2017;175C:8-26.

Beighton P, de Paepe A, Danks D, Finidori G, Gedde-Dahl T, Goodman R, Hall JG, Hollister DW, Horton W, McKusick VA et al. International nosology of heritable disorders of connective tissue, Berlin, 1986. Am J Med Genet.1988;29:581-594.

Seckin U, Tur BS, Yilmaz O, Yagci I, Bodur H, Arasil T. The prevalence of joint hypermobility among high school students. Rheumatol Int.2005;25: 260-263.

Simmonds JV, Keer RJ. Hypermobility and the hypermobility syndrome. Man Ther. 2007;12:298-309.

Klemp P, Williams SM, Stansfield SA. Articular mobility in Maori and European New Zealanders. Rheumatology (Oxford).2002;41 (5):554-557.

Stewart S, Burden S. Does generalised ligamentous laxity increase seasonal incidence of injuries in male first division club rugby players? Br J Sports Med.2004;38:457-460.

Smith R, Damodaran A, Swaminathan S, Campbell R, Barnsley L. Hypermobility and sports injuries in junior netball players. Br J Sports Med.2005;39:628-631.

Klemp P, Stevens JE, Isaacs SA. Hypermobility study in ballet dancers. J Rheumatol. 1984;11 (5):692-696.

Bronner S, Bauer NG. Risk factors for musculoskeletal injury in elite pre-professional modern dancers: A prospecitve cohort prognostic study. Phys Ther Sport.2018;31:42-51.

Pacey V, Nicholson LL, Adams RD, Munn, J, Munns CF. Generalised joint hypermobility and risk of lower limb joint injury during sport. A systematic review with meta-analysis. Am Journal Sports Med.2010;38:1487-1497.

Soper K, Simmonds J, Kaz H, Ninis N. The influence of joint hypermobility on functional movement control in an elite netball population: A preliminary cohort study. Phys Ther Sport.2015;16:127-134.

McCormack M, Briggs J, Hakim A, Grahame R. Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol.2004;31: 173-178.

Briggs J, McCormack M, Hakim AJ, Grahame R. Injury and Joint Hypermobility syndrome in ballet dancers-a 5 year follow-up. Rheumatology.2009;48:1613-1614.

Rombaut L, Malfait F, De Wandele I, Thijs Y, Palmas T, De Paepe A, Calders P. Balance, gait, falls, and fear of falling in women with hypermobility type of Ehlers-Danlos syndrome. Arthritis Care Res.2011;63:1432-1439.

Armstrong R, Greig M. The Beighton score as a predictor of Brighton criteria in Sports and Dance. Phys Ther Sport. 2018.32;145-154.

Finsterbush A, Pogrund H. The hypermobility syndrome: Musculoskeletal complaints in 100 consecutive cases of generalised joint hypermobility. Clin Orthop.1982;168:124-27.

Gannon LM, Bird HA. The quantification of joint laxity in dancers and gymnasts. J Sport Sci.1999;17:743-750.

Graham R, Jenkins JM. Joint hypermobility: an asset or a liability? A study of joint mobility in ballet dancers. Ann Rheum Dis.1972;31:109-111.

Chorba RS, Chorba DJ, Bouillon LE,Overmyer CA, Landis JA. Use of a functional movement screening tool to determine injury risk in female collegiate athletes. N Am J Sports Physical Ther.2010;5:47–54.

Bird HA. Rheumatological aspects of dance. J Rheumatol.2004;31:12-13.

Juul-Kristensen B, Røgind H, Jensen DV, Remvig L. Inter-examiner reproducibility of tests and criteria for generalized joint hypermobility and benign joint hypermobility syndrome. Rheumatology.2007;46:1835-1841.

Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. Journal Strength Cond Res. 2005;19: 231-240.

Remvig L, Duhn PH, Ullman S, Kobayasi T, Hansen B, Juul-Kristensen B, Jurvelin JS, Arokosi. Skin hyperxtensibility and consistency in patients with Ethlers-Danlos syndrome and benign joint hypermobility syndrome. Scand J Rheumatol.2009;38 (3):227-230.

Remvig, L, Duhn, PH, Ullman, S, Arokoski, J, Jurvelin, J, Safi, A et al. Skin signs in Ehlers–Danlos syndrome: clinical tests and para-clinical methods, Scand J Rheumatol.2010; 39 (6):511-517.

Sanches SB, Oliveira GM, Osório FL, Crippa JAS, Martín Santos R. Hypermobility and joint hypermobility syndrome in Brazilian students and teachers of ballet dance. Rheumatol Int.2015;35:741-747.

Oddy C, Johnson MI, Jones G. The effect of generalised joint hypermobility on rate, risk and frequency of injury in male university-level rugby league players: a prospective cohort study. BMJ Open Sport Exerc Med.2016;1:e000177. doi:10.1136.

Russek LN, Errico DM. Prevalence, injury rate and, symptom frequency in generalized joint laxity and joint hypermobility syndrome in a “healthy” college population. Clin Rheumatol. 2016;35:1029-1039.

Foley EC, Bird HA. Hypermobility in dance: asset, not liability. Clin Rheumatol. 2013; 32:455-461.

Keer R, Butler K. Physiotherapy and occupational therapy in the hypermobile adult. In: Hakim AJ, Keer R, Graham R (eds) Hypermobility, fibromyalgia and chronic pain. 1st Edition. Churchill Livingstone, Elseveir, London. pp143-161. 2010.

Ribeiro F, Santos F, Gonclaves P, Oliveira J. Effects of volleyball match-induced fatigue on knee joint position sense. Eur J Sport Sci. 2008;8:397-402.

Cameron KL, Duffey ML, DeBerardino TM, Stoneman PD, Jones CJ, Owens BD. Association of generalized joint hypermobility with a history of glenohumeral joint instability. Journal of Athletic Training.2010;45:253–258.

Chahal J, Leiter J, McKee M D,Whelan DB. Generalized ligamentous laxity as a predisposing factor for primary traumatic anterior shoulder dislocation. J Shoulder Elbow Surg. 2010;19:1238–1242.

Larsson LG, Baum J, Mudholkar GS. Hypermobility: features and differential incidence between the sexes. Arthritis Rheum.1987;30:1426-1430.

Rikken-Bultman DG, Wellink L, van Dongen P. Hypermobility in two Dutch School populations. Eur J Obstet Gynecol Reprod Biol.1997;73:189-192.

Juul-Kristensen, B, Kristensen, JH, Frausing, B, Jensen DV, Røgind H, Remvig L. Motor competence and physical activity in 8-year-old school children with generalized joint hypermobility. Pediatrics.2009;124:1380-1387.

Ruemper A and Watkins K. Correlations between general joint hypermobility and joint hypermobility syndrome and injury in contemporary dance students. J Dance Med Sci.2012; 16:161-166.




DOI: http://dx.doi.org/10.5281/zenodo.1311592

Data citation

N/a

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

https://pbn.nauka.gov.pl/sedno-webapp/search?search&searchCategory=WORK&filter.inJournal=36616

POL-index 2011 - 2014

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-32a319c5-a850-4f44-ba70-1418a6087655

BASE 2011 - 2014

https://www.base-search.net/Search/Results?lookfor=Journal+of+Health+Sciences+%28Radom%29&type=all&oaboost=1&ling=1&name=&thes=&refid=dcrespl&newsearch=1

http://elibrary.ru/contents.asp?titleid=37467

http://journal.rsw.edu.pl/index.php/JHS/issue/archive

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

https://www.ncbi.nlm.nih.gov/nlmcatalog/101679844

Find a library that holds this journal: http://worldcat.org/issn/23918306

Journal Language(s): English 

PBN Poland

https://pbn.nauka.gov.pl/sedno-webapp/journals/49068

POL-index

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-c39c8169-88d2-45db-9e7f-d948ce9981c4

BASE

https://www.base-search.net/Search/Results?join=AND&bool0[]=AND&lookfor0[]=2391-8306&type0[]=all&page=11&l=pl&oaboost=1&refid=dcpagepl

Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2  www.ukw.edu.pl Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy http://ojs.ukw.edu.pl/index.php/johs  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.

http://journals.indexcopernicus.com/Journal+of+Education+Health+and+Sport,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase Index.com.

Website: www.infobaseindex.com

Universal Impact Factor 1.78 for year 2012. (http://www.uifactor.org/AppliedJournals.aspx)

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski

(http://www1.bg.us.edu.pl/bazy/czasopisma/czasop_full.asp?id=3595)