Pain is not associated with activity limitation and generalized joint laxity in children with hypermobility syndrome

Background and Aims: Hypermobility syndrome (HMS) is diagnosed when generalized joint laxity (GJL) is associated with musculoskeletal pain.1 Activity limitation has been found in children with HMS.2 The relationships between pain and activity limitation, and GJL have not been well reported. This study investigated these issues in children with HMS. Methods: Twenty-nine children with HMS aged 8-15 years participated in this investigation. Following ethical approval,informed written consent was obtained from the participants and their parents/guardians. GJL was assessed using the Beighton score.3 Average pain (the more painful knee) was measured with a Colored Analogue Scale. Functional range of movement during walking was examined as a measure of activity limitation using a VICON camera system (Oxford Metrics, England). Spearman Rho correlation analysis was used to determine the relationship between pain, GJL, and activity limitation. Results: No correlation was found between pain and activity limitation (r range = -0.048 to -0.308; all P > 0.05). No relationship was observed between pain and Beington scores (r = -0.096; P > 0.05). Conclusions: There was no relationship between pain and activity limitation, and between pain and GJL in children with HMS. For effective management of HMS, activity limitation should also be examined as an important outcome. A high Beighton score for diagnosing HMS may be inappropriate as some children with low scores could also present with pain and may be missed out during assessment. This paper was presented at the 5th world congress of the world institute of pain, in 2009.