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Beighton Scoring System Use in Generalized Joint Hypermobility Studies Has Greater Scientific Rigor Than
John Nyland1,2, Essa Gul2, Jonathon Lewis1
1Norton Orthopedic Institute Louisville Kentucky U.S.A.
Purpose:
To compare the scientific rigor of Beighton Scoring System (BSS) use in generalized joint hypermobility (JH) studies (healthy subject injury risk/rate, physiological or kinesiological function determination) and joint-specific or arthroscopy JH studies; to identify the most commonly used BSS score thresholds; and to describe ways to improve BSS score use for improved surgical and clinical decision-making.
Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, the PubMed, EBSCO Host, and Web of Science databases were searched using "Beighton score" and "sports injury outcome" terms. Study purpose, publication year, female or male subject number, age and group type, measurement tools, BSS criteria, results, and conclusions data were extracted.
Results:
Twenty-eight generalized JH studies (43.8%, 28/64) involving 12,138 subjects (6512 females) and 36 joint-specific or arthroscopy JH studies (56.3%, 36/64) involving 7351 subjects (3441 females) were identified. Overall, most studies reported that BSS scores influenced most/all (54.7%, n = 35/64) or some (26.6%, 17/64) study outcomes and most were Evidence Level II (57.8%, n = 37/64) or III (35.9%, n = 23/64). Most generalized JH studies used a BSS score ≥4 (n = 13, 46.4%) or BSS ≥5 (n = 7, 25%) while most joint-specific or arthroscopy JH studies used a BSS score ≥4 (n = 17, 47.2%), a BSS score ≥5 (n = 9, 25%), or the full BSS score scale (n = 7, 19.4%). Joint-specific and arthroscopy JH studies were more recently published (2020.2 ± 3.5 vs 2014.2 ± 6.8, P < .001). Generalized JH studies more frequently reported separate subject sex and age data (53.6%, n = 15/28) while joint-specific or arthroscopy JH studies more often combined this information (92.7%, 33/36) (P = .001). Most generalized JH studies were Evidence Level II (85.7%, 24/28) while most joint-specific or arthroscopy JH studies were Evidence Level III (52.8%, 19/36) (P < .001). Group study quality and bias risk was comparable; however, generalized JH studies had more prospective research designs (96.4%, 27/28 vs 58.3%, 21/36 (P < .001).
Conclusions:
Generalized JH studies had more prospective research designs, had higher evidence levels, and more frequently reported separate subject age and sex details. Greater use of these characteristics in joint-specific or arthroscopy JH studies may strengthen surgical and clinical decision-making and patient outcome prediction validity.
Level Of Evidence:
Level IV, narrative review of Level I to IV studies.
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