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Lower Limb Biomechanical Analysis of Healthy Participants
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Lower Limb Biomechanical Observations in Hypermobile Children: An Exploratory Case-Control Study
Muhammad Maarj1,2, Verity Pacey3, Louise Tofts2,3
1School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Ourimbah, NSW 2258, Australia.
International Journal of Environmental Research and Public Health
|December 30, 2025
Summary
Children with generalized joint hypermobility (GJH) exhibit distinct lower limb biomechanics, including increased hip rotation, Q-angle, ankle range of motion (ROM), and foot posture index (FPI). These differences highlight potential injury risks and warrant further investigation into clinical relevance.
Area of Science:
- Biomechanics
- Pediatrics
- Orthopedics
Background:
- Generalized joint hypermobility (GJH) is characterized by excessive joint range of motion.
- GJH is linked to increased risk of musculoskeletal injuries, joint pain, and instability.
- Understanding lower limb biomechanics in children with GJH is crucial for injury prevention.
Purpose of the Study:
- To compare lower limb biomechanical characteristics between children with and without GJH.
- To identify specific biomechanical differences associated with GJH in pediatric populations.
- To explore potential clinical implications of these biomechanical variations.
Main Methods:
- A case-control study comparing 27 children with GJH to 25 age- and sex-matched healthy controls.
- Participants aged 5-18 years were assessed using the Beighton score for GJH diagnosis.
- Biomechanical measures included internal hip rotation, quadriceps (Q) angle, tibial torsion, ankle range of motion (ROM), and foot posture index (FPI).
- Statistical analysis employed Wilcoxon rank sum test and chi-square tests.
Main Results:
- Children with GJH demonstrated significantly higher internal hip rotation, Q-angle, ankle ROM, and FPI compared to controls (p < 0.001).
- Tibial torsion showed no significant difference in males, but females with GJH had greater internal tibial torsion.
- Ankle ROM exhibited the largest differences, with a median difference of 9° in both right and left ankles.
Conclusions:
- Children with GJH exhibit significantly different lower limb biomechanical profiles compared to their non-hypermobile peers.
- These biomechanical variations, particularly in hip, ankle, and foot, may contribute to the increased injury risk associated with GJH.
- Further research is warranted to investigate the clinical relevance of these movement planes not assessed by the Beighton score.
