Hulburt Tessa C, Black William R, Bonnette Scott, Thomas Staci, Schille Andrew, DiCesare Chris, Briggs Matthew S, Ounpuu Sylvia, Kashikar-Zuck Susmita, Myer Greg D
Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; Health Services Research Center, Emory University School of Medicine, Atlanta, GA, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Clin Biomech (Bristol). 2025 Apr;124:106466. doi: 10.1016/j.clinbiomech.2025.106466. Epub 2025 Feb 21.
Joint hypermobility is common in children and persists in various genetic and connective tissue disorders, including conditions characterized by chronic musculoskeletal pain (i.e. Juvenile Fibromyalgia Syndrome), which involves movement dysfunction. It is unclear if joint hypermobility contributes to this dysfunction. This study investigated whether generalized joint hypermobility is associated with altered landing/jumping biomechanics in adolescents with juvenile fibromyalgia syndrome compared to controls.
Adolescents with juvenile fibromyalgia syndrome and hypermobility (n = 17), juvenile fibromyalgia syndrome without hypermobility (n = 17), and non-hypermobile controls (n = 17) performed a landing/jumping task while 3D-motion capture and ground reaction force data were collected. Timewise data were compared using statistical parametric mapping.
Both groups with juvenile fibromyalgia syndrome exhibited altered lower extremity biomechanics compared to controls, including increased sagittal hip and ankle kinematics (P < 0.0001), ∼25 % reduced sagittal knee and ankle kinetics (P ≤ 0.038) and ∼ 2.5× greater knee internal rotation (P < 0.0001) during landing/jumping, as well as ∼75 % and ∼ 20 % reduced ground reaction force during initial landing and jumping (P < 0.0001), respectively. Both groups with juvenile fibromyalgia syndrome, demonstrated 17-26 % reduced landing depth (P < 0.0001;d ≤ 1.79) and 26 % reduced jump height (P ≤ 0.01;d ≤ 0.86), indicating inefficient momentum absorption.
Altered biomechanics observed in both groups with juvenile fibromyalgia syndrome may reflect an attempt to avoid pain. While hypermobility did not significantly differentiate the groups with juvenile fibromyalgia syndrome overall, it was associated with more inefficiencies. This study highlights the need for hypermobility-specific movement assessments to understand movement-associated pain, strength, and kinesthetics to improve early identification and treatment of youth with hypermobility at risk for chronic pain and functional limitations.
关节活动过度在儿童中很常见，并在各种遗传和结缔组织疾病中持续存在，包括以慢性肌肉骨骼疼痛为特征的疾病（即青少年纤维肌痛综合征），这涉及运动功能障碍。目前尚不清楚关节活动过度是否会导致这种功能障碍。本研究调查了与对照组相比，青少年纤维肌痛综合征患者的全身关节活动过度是否与着陆/跳跃生物力学改变有关。
患有青少年纤维肌痛综合征且关节活动过度的青少年（n = 17）、患有青少年纤维肌痛综合征但无关节活动过度的青少年（n = 17）和非关节活动过度的对照组（n = 17）进行着陆/跳跃任务，同时收集三维运动捕捉和地面反作用力数据。使用统计参数映射比较随时间变化的数据。
与对照组相比，两组青少年纤维肌痛综合征患者均表现出下肢生物力学改变，包括着陆/跳跃期间矢状面髋关节和踝关节运动学增加（P < 0.0001），矢状面膝关节和踝关节动力学降低约25%（P ≤ 0.038），膝关节内旋增加约2.5倍（P < 0.0001），以及初始着陆和跳跃期间地面反作用力分别降低约75%和20%（P < 0.0001）。两组青少年纤维肌痛综合征患者的着陆深度降低了17%-26%（P < 0.0001；d ≤ 1.79），跳跃高度降低了26%（P ≤ 0.01；d ≤ 0.86），表明动量吸收效率低下。
在两组青少年纤维肌痛综合征患者中观察到的生物力学改变可能反映了避免疼痛的尝试。虽然关节活动过度总体上没有显著区分青少年纤维肌痛综合征患者组，但它与更多的低效情况有关。本研究强调需要进行针对关节活动过度的运动评估，以了解与运动相关的疼痛、力量和动觉，从而改善对有慢性疼痛和功能受限风险的关节活动过度青少年的早期识别和治疗。
