Boyle investigated the intrarater and interrater reliability of the Beighton and Horan Joint Mobility Index for women aged 15 to 45 years. These results provide a platform to evaluate the relationships between the Beighton criteria and key clinical features (including pain), thereby testing the clinical validity of this scoring system in the pediatric population Īccording to Remvig et al., the Beighton and Horan method for diagnosis of generalized joint laxity showed high kappa values (intraobserver: 0.75 interobserver: 0.78). Evidence of Use Reliability Ĭlinch J et al (2011) showed that the prevalence of hypermobility in UK children is high, possibly suggesting that the Beighton score cutoff of >4 is too low or that this scoring is not appropriate for use in subjects whose musculoskeletal system is still developing. Can you put your hands flat on the floor with your knees straight I am going to bend your elbow backwardsĤ. I am going to bend your thumb back on the front of your forearmģ. I am going to bend your little finger up at 90° to the back of your handĢ. Instructions during the performance of the Beighton scale:ġ. In fact there is no universal agreement on a threshold for BJHMS, some researchers use a Beighton scale score of 5/9, other researchers use a score of 6/9 and still others use a modified score of 3/9. According to the Beighton and Horan criteria, generalized joint laxity is present when four or more of five tests are positive, including contralateral knee hyperextension. The spinal forward flexion criterion differs from the other criteria, in that it measures hamstring flexibility and anatomic proportions to ligamentous laxity.
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According to child (1986), a score of 4 or more out of 9 indicates generalized hypermobility of the joints. Several researchers appoint a score of 0-3 as normal and a score of 4-9 as representing ligamentous laxity (Al - Rawi et al 1985, Diaz et al 1993, Klemp et al 1984). The maximum score for ligament laxity is 9. The first four elements can be given a maximum score of 2, because these are performed bilateral. Active forward flexion of the trunk with the knees fully extended so that the palms of the hands rest flat on the floor Passive hyperextension of the knee beyond 10°ĥ. Passive hyperextension of the elbow beyond 10°Ĥ.
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Passive apposition of the thumb to the flexor aspect of the forearmģ. Passive dorsiflexion and hyperextension of the fifth MCP joint beyond 90°Ģ. The most frequent choice of cutoff was > 4 hypermobile joints īeighton and Horan (1969) revised the test to measure joint laxity in people with Ehlers – Danlos syndrome. Most of the available prevalence studies used different cutoffs, ranging from >3 hypermobile joints to > 6 hypermobile joints of 9 assessed (both thumbs, both little fingers, both elbows, both knees and the trunk), and in some, only the dominant side was assessed. The Beighton score has subsequently been used internationally to define generalized joint laxity in all populations and all age groups. An alternative scale that offers a wider view of joint laxity (including the shoulder, hip, patella, ankle, foot and toes) is the 10 – point hospital Del Mar criteria (Barcelona) (Bulbena et al, 1992) It gives no indication of the degree of hypermobility, merely an expression of the widespread nature of its distribution.
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This is a nine – point scale and requires the performance of 5 maneuvers, four passive bilateral and one active unilateral performance. The Beighton score is a popular screening technique for hypermobility.