"Core" Muscle Endurance, Upper Extremity Muscle Strength, Grip Strength, and Hand-eye Coordination in Generalized Joint Hypermobility
Condition: Hypermobility, Joint; Muscle Weakness; Coordination Lack
MeSH terms: Muscle Weakness; Joint Instability; Ataxia
Study type: Observational [Patient Registry]

Summary: 
      Every individual with joint hypermobility may not apply to a health institution because they
      do not have a complaint that will affect their daily life. Although hypermobility is a common
      clinical entity in the society, this issue has not been fully understood yet. In particular,
      individuals with GJH are either neglected in physiotherapy and rehabilitation evaluations and
      practices, or they encounter an incomplete assessment and physiotherapy practices. In this
      study, in order to better understand the effect of GJH on "core" muscle endurance, upper
      extremity strength, grip strength and coordination, we will include the individuals
      identified GJH among the university students (hypermobility severity ≥4/9 according to
      Beighton diagnostic criteria) as study group and the healthy peers as control group. We
      believe the results we will obtain at the end of our study will make a contribution to the
      literature in terms of revealing the role of "core" muscle endurance and upper extremity
      strength, grip strength and coordination in the evaluation and rehabilitation of individuals
      with GJH. In addition, it will contribute to the inclusion of individuals with GJH who are
      professional athletes, dancers or musicians in a more comprehensive evaluation program and
      the creation of physiotherapy and rehabilitation programs.

      According to the information we have obtained from the literature, it is a fact that
      hypermobility can increase the susceptibility to musculoskeletal system diseases. For this
      reason, early solutions to problems can be provided by evaluating hypermobility in patients
      who apply to health institutions with various musculoskeletal complaints, raising awareness
      of patients with hypermobility to prevent injuries caused by hypermobility, and strengthening
      muscles.
    

Detailed description: 
      Many people may have more than one hypermobile joint, and when certain conditions are met,
      this condition called generalized joint hypermobility (GJH) is not detrimental. In recent
      years, the spectrum of the disorder has been changed in the classification of joint
      hypermobility, from asymptomatic GJH to the multisystem involvement and painful condition
      called hypermobile Ehlers Danlos Syndrome. Beighton criteria are most commonly used in the
      diagnosis of hypermobility. The Beighton score is an easy scoring method that is scored by
      performing five maneuvers and includes a total of nine points. If four of these maneuvers are
      positive, the patient is considered to have hypermobility. Numerous studies associate
      hypermobility with conditions such as soft tissue injuries, pain, joint instability,
      decreased soft tissue strength, increased frequency of traumatic injuries, and pain-related
      inactivity.

      The study was designed as a cross-sectional descriptive and comparative study. With this
      study, in order to better understand the effect of GJH on core muscle endurance, upper
      extremity strength, grip strength, and coordination, we aim to include volunteers with
      identified GEH among the university students (hypermobility severity ≥4/9 according to
      Beighton diagnostic criteria). 27 students between the ages of 17-26 who are studying at the
      Faculty of Health Sciences of Bezmialem Vakif University and scored 4 and above according to
      the Beighton score, and the 27 students who are in the same age group studying at the same
      faculty, do not have GJH will be included. In the study, after evaluating flexibility with
      sit-reach test, core muscle endurance, upper extremity muscle strength, hand grip strength,
      finger grip strength and hand-eye coordination tests will be applied to all participants.
      SPSS v.20 program will be used for data analysis. All data will be analyzed with the
      Kolmogorov-Smirnov test to determine the distribution characteristics. In the study,
      descriptive statistics (mean±standard deviation, minimum-maximum, number and percentile) will
      be given for discrete and continuous variables. When the differences between two independent
      groups are evaluated, "t-Test in Independent Groups" in case the parametric test
      prerequisites are met; If not, the "Mann Whitney -U Test" will be used. "Chi-Square Test"
      will be used to determine the relationships between two discrete variables. When the
      variables meet the parametric test prerequisites, the correlation coefficients and
      statistical significance will be calculated with the "Pearson Test", when they do not, the
      correlation coefficients and statistical significance for the relations between the variables
      will be calculated with the "Spearman Test".

      Although there are studies in the literature evaluating muscle strength, grip strength and
      trunk endurance in individuals with joint hypermobility, no study evaluating hand-eye
      coordination has been encountered. However, no study has been encountered that evaluated core
      muscle endurance, upper extremity strength, grip strength, and hand-eye coordination in
      individuals with GJH. We believe that the results we will obtain at the end of our study will
      contribute to the literature in terms of revealing the role of core muscle endurance and
      upper extremity strength, grip and coordination in the evaluation and rehabilitation of
      individuals with GJH.
    

Intervention name(s): Core muscle endurance; Upper extremity muscle strength; Grip strength; Pinch strength; Alternate hand-wall toss test
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): Trunk flexion, trunk extension, side bridge exercises and prone bridge test developed by McGill will be used to evaluate core muscle endurance.; Isometric muscle strength assessment of the shoulder, elbow and wrist muscles will be performed with a hand-held dynamometer.; Grip strength will be evaluated with a hand dynamometer in the position recommended by the American Association of Hand Therapists.; Pinch strength will be evaluated with a pinchmeter in three positions.; To measure hand-eye coordination, it is performed by changing hands by throwing and catching the ball against the wall.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Young adults between the ages of 17-26 years with a score of 4 or higher according to the
        Beighton criteria.