Joint Hypermobility may increase risk of injury among patients with Juvenile Fibromyalgia

A recent study published in BMC Pediatrics delves into the biomechanical variances observed in adolescent patients diagnosed with juvenile fibromyalgia (JFM) and joint hypermobility, shedding light on potential implications for treatment and physical functioning in this population.

The investigation, led by William R Black, PhD, pediatric psychologist and assistant professor at the University of Kansas School of Medicine, sought to understand the impact of joint hypermobility on pain, biomechanics, and daily functioning in adolescent patients aged 12 to 18 years diagnosed with JFM. Joint hypermobility was assessed using the Beighton Score, while pain intensity was measured using the Visual Analog Scale (VAS).

Among the 36 patients in the study, 13 adolescents exhibited joint hypermobility, accounting for 36.1% of the cohort, while 23 did not meet the diagnostic criteria for this condition. Notably, the study found that as functional disability increased, Beighton scores decreased, suggesting that higher scores were associated with better physical function.

Patients with both JFM and joint hypermobility demonstrated poorer overall functioning compared to their counterparts without joint hypermobility. However, intriguingly, there were no significant differences in reported pain intensity between the two groups.

Biomechanical analysis during a moderately vigorous functional task, the drop vertical jump (DVJ), revealed distinctive patterns in patients with joint hypermobility. These individuals exhibited increased hip flexion throughout the DVJ task and demonstrated decreased hip frontal plane abduction movement during the early stance phase, along with greater hip and knee transverse plane moments during the late stance phase.

Dr. Black and colleagues highlighted the study's limitations, notably the small sample size, which might have restricted the detection of significant differences between the groups. Additionally, they emphasized the need for future research to explore whether these biomechanical differences could impact responses to physical therapy or exercise programs in patients with joint hypermobility and chronic musculoskeletal pain conditions.

The study tentatively supports the use of neuromuscular training and exercise programming in adolescents dealing with chronic musculoskeletal pain, regardless of their joint hypermobility status. However, the researchers stress the necessity for further investigations to validate these findings and address potential errors.

Reference:

Black WR, DiCesare CA, Wright LA, et al. The effects of joint hypermobility on pain and functional biomechanics in adolescents with juvenile fibromyalgia: secondary baseline analysis from a pilot randomized controlled trial. BMC Pediatr. 2023;23(1):557. Published 2023 Nov 6. doi:10.1186/s12887-023-04353-y