Identifying lower limb specific and generalised joint hypermobility in adults: validation of the Lower Limb Assessment Score

BMC Musculoskeletal Disorders

Research Article

Leslie L. Nicholson¹  Cliffton Chan¹  Kaitlin J. Meyer²  Luke Hopper³ 

[1] Discipline of Biomedical Science, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia;Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia;Western Australian Academy of Performing Arts, Edith Cowan University, Perth, Western Australia, Australia;

关键词: Joint hypermobility;    Joint instability;    Joint laxity;    Lower extremity;    Screening tool;    Manual tests;    Orthopaedic tests;   

DOI  :  10.1186/s12891-017-1875-8

 received in 2017-06-15, accepted in 2017-11-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Lower Limb Assessment Score (LLAS) has only been validated in a paediatric population. The aim of this study was to validate the use of the LLAS in an adult population by: i) evaluating its ability to discriminate between different extents of lower limb hypermobility, ii) establishing a cut-off score to identify lower limb hypermobility, and iii) determining if the LLAS is able to identify Generalised Joint Hypermobility (GJH).MethodsParticipants were recruited across three groups representing varying degrees of hypermobility. They were assessed using the LLAS, Beighton score and clinical opinion. Pearson’s correlation coefficient and MANOVA were used to assess between-group differences in the LLAS. The cut-off score was determined using median and inter-quartile ranges and the Receiver Operator Characteristic Curve. The ability of the LLAS to identify GJH was assessed using percent agreement with clinical opinion.ResultsOne hundred twelve participants aged 18–40 years were recruited. The LLAS distinguished the control from the likely hypermobile and known hypermobile cohorts (both p < 0.001), as well as the likely hypermobile from the known hypermobile cohort (p = 0.003). The LLAS cut-off score for identifying lower limb hypermobility was ≥7/12 with a specificity of 86% and sensitivity of 68%. The LLAS accurately identified those with GJH with high percentage agreement compared to clinical opinion across all cohorts (69–98%).ConclusionsThe LLAS is a valid tool for identifying lower limb specific hypermobility and GJH in adults at a cut-off score of ≥7/12. It demonstrates excellent specificity and moderate sensitivity, and discriminates well between extents of hypermobility.

【 授权许可】

CC BY   
© The Author(s). 2017