"Core" Muscle Endurance, Upper Extremity Muscle Strength, Grip Strength, and Hand-eye Coordination in Generalized Joint Hypermobility

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.

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.

Eligibility Criteria:
Inclusion Criteria:

* Getting a score of 4 or higher according to the Beighton criteria
* Being between the ages of 17-26

Exclusion Criteria:

* Presence of benign joint hypermobility syndrome
* Presence of any neurological, rheumatic, musculoskeletal, metabolic and connective tissue disease
* History of fracture in the upper extremity
* History of pain, deformity or surgery associated with the vertebral column and upper extremity
* Presence of cognitive, mental and/or serious psychiatric illness
* Participating in any exercise program or sportive activity in the last six months