de Boer Rosa M, van Vlimmeren Leo A, Scheper Mark C, Nijhuis-van der Sanden Maria W G, Engelbert Raoul H H
Primary Practice for Pediatric Physiotherapy, Heerhugowaard, The Netherlands.
Department of Rehabilitation, Pediatric Physical Therapy, Radboud University Medical Center, Nijmegen, The Netherlands; Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
J Pediatr. 2015 Sep;167(3):694-701.e1. doi: 10.1016/j.jpeds.2015.06.034. Epub 2015 Jul 17.
To determine the prevalence of generalized joint hypermobility (GJH) in Dutch children aged 5.5 years, and to examine the association between GJH and motor performance and development over time.
A prospective cohort of 249 children was recruited. GJH was assessed with the Beighton test at age 5.5 years. Motor performance was evaluated at age 2.0 years using the Bayley Scales of Infant Development, Second Edition and at age 5.5 years using the Movement Assessment Battery for Children-Second Edition (subscore categories: manual dexterity, aiming and catching, and static and dynamic balance).
In 249 children, the prevalence of GJH, defined by the Beighton test score, was 34.1% for a score ≥ 4, 22.5% for a score ≥ 5, and 16.5% for a score ≥ 6. No significant association was found between GJH and total motor performance. Manual dexterity in girls (Beighton score ≥ 4) was positively associated with higher level of motor performance (β [SE] = 0.38 [0.17]; P = .028), ranging from +0.04 SD to +0.72 SD, even after correction for covariates. A significant interaction between GJH and body mass index (BMI) growth was found, indicating that the effect of GJH on the rate of development of motor performance declines with increasing BMI growth (β = 0.05 [0.02]; P = .031).
In this healthy pediatric cohort, GJH was present in one-third of the sample, and no significant association was found between GJH and total motor performance. The effect of GJH on the rate of development of motor performance appears to decline with increasing BMI growth. Longitudinal prospective studies are recommended to detect influences of GJH on motor performance over time, as well as the influence of body composition and Beighton cutoff points.
确定5.5岁荷兰儿童中全身关节活动过度（GJH）的患病率，并研究GJH与运动能力及随时间的发育之间的关联。
招募了249名儿童组成的前瞻性队列。在5.5岁时用贝顿测试评估GJH。在2.0岁时使用贝利婴幼儿发展量表第二版评估运动能力，在5.5岁时使用儿童运动评估量表第二版（子分数类别：手部灵巧性、目标瞄准与接球、静态和动态平衡）进行评估。
在249名儿童中，根据贝顿测试分数定义的GJH患病率，分数≥4时为34.1%，分数≥5时为22.5%，分数≥6时为16.5%。未发现GJH与总体运动能力之间存在显著关联。女孩（贝顿分数≥4）的手部灵巧性与较高水平的运动能力呈正相关（β[标准误]=0.38[0.17]；P=0.028），范围从+0.04标准差到+0.72标准差，即使在对协变量进行校正后也是如此。发现GJH与体重指数（BMI）增长之间存在显著交互作用，表明随着BMI增长增加，GJH对运动能力发育速度的影响会下降（β=0.05[0.02]；P=0.031）。
在这个健康的儿科队列中，三分之一的样本存在GJH，未发现GJH与总体运动能力之间存在显著关联。随着BMI增长增加，GJH对运动能力发育速度的影响似乎会下降。建议进行纵向前瞻性研究，以检测GJH随时间对运动能力的影响，以及身体成分和贝顿切点的影响。
