Judging heel height: A new test for proprioception while standing reveals that young hypermobile children perform...

Children with Generalized Joint Hypermobility (GJH) have been reported to have poorer proprioception than children with normal mobility. However, they were usually tested under unloaded conditions and in an age-group in which pain starts to play a role.

In contrast, some young children with GJH perform well in motor tasks, suggesting they may have good proprioceptive abilities if assessed more ecologically.

Children with GJH (Beighton score of  ≥ 5; mean age 8.34 years) were compared to children with a Beighton score of 4 or less. A proprioception test was performed using wedges of different heights to evaluate the ability to judge heel height. A pair of wedges of various heights, was placed under the children's feet at random and they were required to report the higher leg while standing RESULTS: Independent t-test showed that children with GJH performed better (p < 0.01) than controls, suggesting better proprioceptive abilities when assessed under loaded conditions SIGNIFICANCE: Children with GJH do not have inferior proprioception when tested under loaded conditions. The least one can say is that one should be careful in postulating that measuring passive position sense in one particular joint is necessarily the best estimation of proprioception. Body position during standing can be estimated on the basis of knowledge of joint positions (of the ankle in particular in the present test) but also of other information (loading of foot mechanoreceptors for example). In conclusion, the new test may be more suited to evaluate proprioception than the conventional tests, which rely on passive joint position estimation during sitting.