Does asymptomatic generalized joint hypermobility influence musculotendinous extensibility and knee joint proprioception?

Authors

  • Pawan Chaiparinya Faculty of Allied Health Science, Chulalongkorn University, Bangkok, Thailand.
  • Sujitra Boonyong Faculty of Allied Health Science, Chulalongkorn University, Bangkok, Thailand.
  • Chitanongk Gaogasigam Faculty of Allied Health Science, Chulalongkorn University, Bangkok, Thailand.

Keywords:

Generalized joint hypermobility, hamstrings, quadriceps, knee joint, proprioception

Abstract

Background: It is unclear whether generalized joint hypermobility (GJH) influences the musculotendinous unit (MTU) extensibility or proprioception of the knee joint in individuals with asymptomatic GJH.

Objectives: This study aimed to compare the quadriceps and hamstring MTU length as well as knee joint force sense (FS) and joint position sense (JPS) between individuals with asymptomatic GJH and non-GJH controls.

Methods: Thirty-two female subjects were recruited, with 16 subjects in the GJH and non-GJH groups. The angles measured from modified prone knee bend (mPKB) and straight leg raising (SLR) tests were used to identify the quadriceps and hamstrings MTU extensibility using photographic-based angle measurements. The FS of the quadriceps and hamstrings and the JPS of the knee joint were assessed via ipsilateral angle and force-matching tasks, respectively. The results from the GJH and non-GJH groups were compared using unpaired t - tests or chi-square tests based on the distribution of the data.

Results: The results indicated that the angles measured by the mPKB and SLR tests were not significantly different between the two groups. Furthermore, neither FS nor JPS differed between the GJH group and their peers.

Conclusion: The asymptomatic GJH individuals did not show signs of hyperextensibility of the quadriceps or hamstring muscles. Moreover, the ability to perceive muscle force and the joint position of the knee joint were well preserved.

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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 C: Semin Med Genet 2017;175:148-57.

https://doi.org/10.1002/ajmg.c.31539

Grahame R. Hypermobility: an important but often neglected area within rheumatology. Nat Clin Pract Rheumatol 2008;4:522-4.

https://doi.org/10.1038/ncprheum0907

Remvig L, Jensen DV, Ward RC. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature. J Rheumatol 2007;34:804-9.

Juul-Kristensen B, Schmedling K, Rombaut L, Lund H, Engelbert RH. Measurement properties of clinical assessment methods for classifying generalized joint hypermobility-A systematic review. Am J Med Genet C Semin Med Genet 2017;175:116-47.

https://doi.org/10.1002/ajmg.c.31540

Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis 1973;32:413-8.

https://doi.org/10.1136/ard.32.5.413

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 2018;21:1787-92.

https://doi.org/10.1111/1756-185X.12883

Junge T, Henriksen P, Hansen S, Østengaard L, Golightly YM, Juul-Kristensen B. Generalised joint hypermobility and knee joint hypermobility:prevalence, knee joint symptoms and health-related quality of life in a Danish adult population. Int J Rheum Dis 2019;22:288-96.

https://doi.org/10.1111/1756-185X.13205

Stettler M, Luder G, Schmid S, Mueller Mebes C, Stutz U, Ziswiler HR, et al. Passive anterior tibial translation in women with and without joint hypermobility: an exploratory study. Int J Rheum Dis 2018;21:1756-62.

https://doi.org/10.1111/1756-185X.12917

Fukunaga T, Kawakami Y, Kubo K, Kanehisa H. Muscle and tendon interaction during human movements. Exerc Sport Sci Rev 2002;30:106-10.

https://doi.org/10.1097/00003677-200207000-00003

Hall MG, Ferrell WR, Sturrock RD, Hamblen DL, Baxendale RH. The effect of the hypermobility syndrome on knee joint proprioception. Rheumatology 1995;34:121-5.

https://doi.org/10.1093/rheumatology/34.2.121

Junge T, Wedderkopp N, Thorlund JB, Søgaard K, JuulKristensen B. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with generalised joint hypermobility. A substudy of the CHAMPS-study Denmark. J Electromyogr Kinesiol 2015;25:501-7.

https://doi.org/10.1016/j.jelekin.2015.02.011

Tobias JH, Deere K, Palmer S, Clark EM, Clinch J. Joint hypermobility is a risk factor for musculoskeletal pain during adolescence: findings of a prospective cohort study. Arthritis Rheum 2013;65:1107-15.

https://doi.org/10.1002/art.37836

Juul-Kristensen B, Hansen H, Simonsen EB, Alkjær T, Kristensen JH, Jensen BR, et al. Knee function in 10-year-old children and adults with generalised joint hypermobility. Knee 2012;19:773-8.

https://doi.org/10.1016/j.knee.2012.02.002

Jensen BR, Olesen AT, Pedersen MT, Kristensen JH, Remvig L, Simonsen EB, et al. Effect of generalized joint hypermobility on knee function and muscle activation in children and adults. Muscle Nerve 2013;48:762-9.

https://doi.org/10.1002/mus.23802

Magnusson SP, Julsgaard C, Aagaard P, Zacharie C, Ullman S, Kobayasi T, et al. Viscoelastic properties and flexibility of the human muscle-tendon unit in benign joint hypermobility syndrome. J Rheumatol 2001;28:2720-5.

Rombaut L, Malfait F, De Wandele I, Mahieu N, Thijs Y, Segers P, et al. Muscle-tendon tissue properties in the hypermobility type of Ehlers-Danlos syndrome. Arthritis Care Res (Hoboken) 2012;64:766-72.

https://doi.org/10.1002/acr.21592

Alsiri N, Al-Obaidi S, Asbeutah A, Almandeel M,Palmer S. The impact of hypermobility spectrum disorders on musculoskeletal tissue stiffness: an exploration using strain elastography. Clin Rheumatol 2019;38:85-95.

https://doi.org/10.1007/s10067-018-4193-0

Marshall PW, Mannion J, Murphy BA. Extensibility of the hamstrings is best explained by mechanical components of muscle contraction, not behavioral measures in individuals with chronic low back pain. PM R 2009;1:709-18.

https://doi.org/10.1016/j.pmrj.2009.04.009

Fatoye F, Palmer S, Macmillan F, Rowe P, van der Linden M. Proprioception and muscle torque deficits in children with hypermobility syndrome. Rheumatology (Oxford) 2009;48:152-7.

https://doi.org/10.1093/rheumatology/ken435

Sahin N, Baskent A, Cakmak A, Salli A, Ugurlu H, Berker E. Evaluation of knee proprioception and effects of proprioception exercise in patients with benign joint hypermobility syndrome. Rheumatol Int 2008;28:995-1000.

https://doi.org/10.1007/s00296-008-0566-z

Smith TO, Jerman E, Easton V, Bacon H, Armon K, Poland F, et al. Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis. Rheumatol Int 2013;33:2709-16.

https://doi.org/10.1007/s00296-013-2790-4

Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev 2012;92:1651-97.

https://doi.org/10.1152/physrev.00048.2011

Rombaut L, De Paepe A, Malfait F, Cools A, Calders P. Joint position sense and vibratory perception sense in patients with Ehlers-Danlos syndrome type III (hypermobility type). Clin Rheumatol 2010;29:289-95.

https://doi.org/10.1007/s10067-009-1320-y

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;46:1835-41.

https://doi.org/10.1093/rheumatology/kem290

Scheper MC, de Vries JE, de Vos R, Verbunt J, Nollet F, Engelbert RH. Generalized joint hypermobility in professional dancers: a sign of talent or vulnerability? Rheumatology (Oxford) 2013;52:651-8.

https://doi.org/10.1093/rheumatology/kes220

Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 1982;36:936-42.

https://doi.org/10.1093/ajcn/36.5.936

Dunlevy C, Cooney M, Gormely J. Procedural considerations for photographic based joint angle measurements. Physiother Res Int 2005;10:190-200.

https://doi.org/10.1002/pri.9

Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012;9:671-5.

https://doi.org/10.1038/nmeth.2089

Witvrouw E, Danneels L, Asselman P, D'Have T, Cambier D. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. Am J Sports Med 2003;31:41-6.

https://doi.org/10.1177/03635465030310011801

Stillman BC, Tully EA, McMeeken jm. Knee joint mobility and position sense in healthy young adults. Physiotherapy 2002;88:553-60.

https://doi.org/10.1016/S0031-9406(05)60138-1

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

https://doi.org/10.1016/j.math.2007.05.001

Ewertowska P, Trzaskoma Z, Sitarski D, Gromu³ B, Haponiuk I, Czaprowski D. Muscle strength, muscle power and body composition in collegeaged young women and men with Generalized Joint Hypermobility. PloS One 2020;15:e0236266.

https://doi.org/10.1371/journal.pone.0236266

Long M, Kiru L, Kassam J, Strutton PH, Alexander CM. An investigation of the control of quadriceps in people who are hypermobile; a case control design. Do the results impact our choice of exercise for people with symptomatic hypermobility? BMC Musculoskelet Disord 2022;23:607.

https://doi.org/10.1186/s12891-022-05540-1

Stillman BC, McMeeken JM. The role of weightbearing in the clinical assessment of knee joint position sense. Aust J Physiother 2001;47:247-53.

https://doi.org/10.1016/S0004-9514(14)60272-5

Ghiasi F, Akbari A. Comparison of the effects of open and closed kinematic chain and different target position on the knee joint position sense. J Med Sci 2007;7:969-76.

https://doi.org/10.3923/jms.2007.969.976

Hu X, Li J, Wang L. Sex differences in lower limb proprioception and mechanical function among healthy adults. Motor Control 2020;24:571-87.

https://doi.org/10.1123/mc.2020-0015

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Published

2024-01-01

How to Cite

1.
Chaiparinya P, Boonyong S, Gaogasigam C. Does asymptomatic generalized joint hypermobility influence musculotendinous extensibility and knee joint proprioception?. Chula Med J [Internet]. 2024 Jan. 1 [cited 2024 Dec. 22];68(1). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/1239