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Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis

Rheumatology International volume 33, pages 2709–2716 (2013)Cite this article

Abstract

Joint proprioceptive deficit is documented in a variety of musculoskeletal conditions including osteoarthritis, ligament and meniscal injuries, and individuals with increased joint hypermobility, such as those with Ehlers–Danlos. No systematic reviews have assessed joint proprioception in people with benign joint hypermobility syndrome (BJHS). This study addresses this to determine whether people with BJHS exhibit reduced joint proprioception, and, if so, whether this is evident in all age groups. The search strategy was conducted on 31st January 2013. The published literature was assessed using the databases: AMED, CINAHL, MEDLINE, EMBASE, PubMed and the Cochrane Library. Unpublished literature and trial registries were assessed including: OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, the UK National Research Register Archive. All studies comparing the proprioceptive capability of people with and without BJHS were included. Study methodological quality was assessed using the CASP appraisal tool. Meta-analysis techniques were used when study homogeneity permitted. Five studies including 254 people were identified. People with BJHS demonstrated statistically significantly poorer lower limb joint position sense (JPS) (p < 0.001) and threshold detection to movement (p < 0.001) than those without BJHS. The evidence for upper limb proprioceptive difference was less clear, with no statistically significant difference between the cohorts for shoulder JPS (p = 0.10), but a statistically significant difference in finger JPS (p < 0.001). One study which assessed childhood BJHS reported reduced knee proprioceptive capability in those with BJHS (p < 0.001). To conclude, lower limb joint proprioception is reduced in those with BJHS compared to non-BJHS cohorts, whilst unclear in the upper limb.

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Acknowledgments

We would like to thank the Information Services at the University of East Anglia’s Library for their assistance in gathering the academic papers required for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK

    Toby O. Smith, Fiona Poland & Alex J. Macgregor

  2. Therapy Department, Norwich Community Health and Care NHS Trust, Norwich, UK

    Emma Jerman

  3. Jenny Lind Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK

    Victoria Easton, Holly Bacon & Kate Armon

  4. Queen’s Building, School of Allied Health Professions, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK

    Toby O. Smith

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  1. Toby O. Smith
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Correspondence to Toby O. Smith.

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Smith, T.O., Jerman, E., Easton, V. et al. Do people with benign joint hypermobility syndrome (BJHS) have reduced joint proprioception? A systematic review and meta-analysis. Rheumatol Int 33, 2709–2716 (2013). https://doi.org/10.1007/s00296-013-2790-4

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  • DOI: https://doi.org/10.1007/s00296-013-2790-4

Keywords

  • Proprioception
  • Joint position sense
  • Benign joint hypermobility syndrome