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Analysis of joint mobility patterns among preschool children
Neuseli Marino Lamari1, Alceu Gomes Chueire, José Antonio Cordeiro
1Department of Orthopedics and Traumatology, Physiotherapy Service, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil. neuselim@terra.com.br
Insights
Joint hypermobility (JH) is common in preschool children, with current assessment methods being inadequate. Further research is needed to develop better criteria for identifying JH in this age group.
Area of Science:
- Pediatrics
- Orthopedics
- Developmental Biology
Background:
- Standardizing normal joint mobility criteria for preschool children is challenging.
- Differentiating normal joint mobility from joint hypermobility (JH) is particularly difficult in this age group.
Purpose of the Study:
- To investigate joint mobility in preschool children across various joints (fifth finger, wrist, elbow, knee, trunk).
- To estimate the incidence of JH in this population.
- To evaluate the influence of gender and age on joint mobility and assess the applicability of standard criteria for identifying JH.
Main Methods:
- A cross-sectional descriptive and quantitative study was conducted with 1,120 healthy preschool children (ages 4-7).
- The Beighton score was used, assessing passive fifth finger extension, thumb-to-forearm apposition, elbow and knee extension, and trunk flexion.
- Joint hypermobility was defined as a Beighton score > 4.
Main Results:
- Joint hypermobility was highly prevalent: 80% in wrists, 53.3% in fifth fingers, and 36.6% in elbows.
- Overall, 64.6% of children scored > 4, indicating JH.
- Females exhibited higher angular values, while older children had lower scores.
Conclusions:
- Joint hypermobility is a common condition in preschool children.
- Current methods for identifying JH in this age group are inadequate.
- New parameters and criteria are necessary for accurate JH identification in preschool children.
Context And Objective:
Standardization of normal joint mobility criteria is complex, especially for preschool children, for whom differentiation from hypermobility (JH) is even more difficult. This study aimed to investigate joint mobility of the fifth finger, wrist, elbow, knee and trunk among preschool children, estimate the incidence of JH and evaluate the effect of gender and age and the applicability of standard criteria for identifying JH among preschool children.
Design And Setting:
Cross-sectional descriptive and quantitative study, at São José do Rio Preto medical school.
Methods:
1,120 healthy children (534 boys, 47.7%; 586 girls, 52.3%; age range: 4-7 years) were evaluated using Beighton scores. Passive extension of fifth finger (> 90 degrees), passive apposition of thumb to forearm, active extension of elbow and knee (> 10 degrees) and anterior trunk flexion placing flat hand on ground were assessed. One point was scored for each positive result (maximum: 9). Scores > 4 were considered to be JH. Students t test and variance analysis were used for statistical analysis.
Results:
JH was observed in 80% of wrists, 53.3% of fifth fingers, 36.6% of elbows, 14% of trunks and 12.5% of knees. Scores > 4 were found for 64.6% of the children. Females had higher angular values. Lower scores were associated with greater age.
Conclusions:
JH is a common condition among preschool children and currently available methods are inadequate. New parameters and criteria should be developed for identifying JH among these children.
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