ALMohiza Mohammad A, Reddy Ravi Shankar
Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11421, Saudi Arabia.
Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.
J Orthop Surg Res. 2025 Mar 14;20(1):285. doi: 10.1186/s13018-025-05683-6.
HMS is characterized by excessive joint mobility, presenting various physical and psychological challenges. Understanding the interplay between these factors is essential for effective HMS management. This study aimed to examine differences in Limits of Stability (LOS) and lumbar proprioception between Hypermobility Syndrome (HMS) and control groups, explore correlations between LOS and proprioception errors, and understand the mediation effects of Kinesiophobia and fatigue on proprioception in HMS individuals.
In this cross-sectional study, 72 HMS patients and 72 control participants were assessed. LOS was evaluated using a computerized Iso-free stabilometric force platform, lumbar proprioception was measured with digital inclinometers, and Kinesiophobia was quantified using the Tampa Scale of Kinesiophobia (TSK). Fatigue was assessed through standardized fatigue scales. Pearson correlation and mediation analyses were employed for statistical examination.
Individuals with HMS showed significantly lower LOS (mean differences ranging from 7.79 to 37.69%) and higher lumbar proprioception errors (mean differences from - 1.09° to -2.88°) compared to the control group. Moderate negative correlations between LOS and proprioception errors were observed (r values from - 0.45 to -0.60). Mediation analysis revealed significant roles of Kinesiophobia (indirect coefficient = -0.14, p = 0.049) and fatigue (indirect coefficient = -0.135, p = 0.047) in the relationship between LOS and proprioception.
This study highlights significant balance and proprioception deficits in HMS individuals, with substantial mediation effects of psychological and physical factors. These findings emphasize the need for an integrated approach in HMS management, combining physical therapy with psychological interventions.
高活动度综合征（HMS）的特征是关节活动过度，带来各种身体和心理挑战。了解这些因素之间的相互作用对于有效管理HMS至关重要。本研究旨在探讨高活动度综合征（HMS）组与对照组在稳定极限（LOS）和腰椎本体感觉方面的差异，探索LOS与本体感觉误差之间的相关性，并了解恐动症和疲劳对HMS个体本体感觉的中介作用。
在这项横断面研究中，对72例HMS患者和72名对照参与者进行了评估。使用计算机化的等动自由稳定测力平台评估LOS，用数字倾角仪测量腰椎本体感觉，使用坦帕恐动症量表（TSK）对恐动症进行量化。通过标准化疲劳量表评估疲劳。采用Pearson相关性分析和中介分析进行统计学检验。
与对照组相比，HMS个体的LOS显著降低（平均差异为7.79%至37.69%），腰椎本体感觉误差更高（平均差异为-1.09°至-2.88°）。观察到LOS与本体感觉误差之间存在中度负相关（r值为-0.45至-0.60）。中介分析显示，恐动症（间接系数=-0.14，p=0.049）和疲劳（间接系数=-0.135，p=0.047）在LOS与本体感觉的关系中起显著作用。
本研究突出了HMS个体存在显著的平衡和本体感觉缺陷，心理和生理因素具有实质性中介作用。这些发现强调了在HMS管理中需要采用综合方法，将物理治疗与心理干预相结合。
