Jaffe M, Tirosh E, Cohen A, Taub Y
Department of Paediatrics, Haifa Medical Center, (Rothschild), Faculty of Medicine, Israel.
Arch Dis Child. 1988 Feb;63(2):158-61. doi: 10.1136/adc.63.2.159.
The association of joint hypermobility and motor development was sequentially investigated in 715 infants from the ages of 8 to 14 months. Seven joints were evaluated for mobility, and each infant underwent a physical and neurological examination. Parents were given a Denver Developmental Parents' Questionnaire. All subjects with a general developmental delay, systemic illness or syndrome were excluded. The infants were classified as having normal or delayed motor development with normal or delayed joint mobility. They were re-examined six months later. Multivariate statistical techniques was used for categorical analysis, and three joints were found to be significantly associated with motor delay at the first examination--hip abduction, elbow hyperextension, and foot dorsiflexion. Of the 715 infants, 126 had joint hypermobility and of these 38 (30.2%) had motor delay. Sixty four of 589 (10.9%) with normal joints had delayed motor development. Six months later 23 out of 35 of the group with joint hypermobility and 42 out of 53 of the group with normal joints had normal motor function. Joint hypermobility is associated with an increased incidence of motor delay in infancy. Over the ensuing six months most of the subjects will catch up. These findings, indicating a favourable prognosis, have implications regarding clinical assessment and parental counselling.
对715名8至14个月大的婴儿依次进行了关节活动过度与运动发育之间关系的研究。评估了七个关节的活动度，并且对每个婴儿进行了体格检查和神经学检查。向家长发放了丹佛发育家长问卷。所有存在一般发育迟缓、全身性疾病或综合征的受试者均被排除。将婴儿分为运动发育正常或延迟且关节活动度正常或延迟的类别。六个月后对他们进行了复查。采用多变量统计技术进行分类分析，发现在第一次检查时有三个关节与运动延迟显著相关——髋关节外展、肘部过度伸展和足背屈。在715名婴儿中，126名有关节活动过度，其中38名（30.2%）存在运动延迟。589名关节正常的婴儿中有64名（10.9%）运动发育延迟。六个月后，关节活动过度组的35名中有23名、关节正常组的53名中有42名运动功能正常。关节活动过度与婴儿期运动延迟发生率增加有关。在随后的六个月里，大多数受试者会追赶上来。这些表明预后良好的发现对临床评估和家长咨询具有启示意义。
