ab224020

Functional ability and physical and psychosocial well-being of hypermobile schoolchildren

N. Ruperto¹, C. Malattia², M. Bartoli², L. Trail¹, A. Pistorio³, A. Martini¹, A. Ravelli¹

¹Dipartimento di Pediatria, Universitá di Genova, Unitá Operativa Pediatria II, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova; ²Dipartimento di Pediatria, Universitá di Pavia, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, Pavia; ³Servizio di Epidemiologia Clinica e Biostatistica, Direzione Scientifica, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova, Italy.

ABSTRACT
Objective
To compare the functional ability and the physical and psychosocial well-being of children with joint hypermobility to those of age- and sex-matched non-hypermobile subjects.

Methods
311 healthy Italian schoolchildren aged 6.3 to 19.3 years were examined for hypermobility of the joints. Functional ability was assessed through the Childhood Health Assessment Questionnaire (CHAQ) and the physical and psychosocial well-being through the Childhood Health Questionnaire (CHQ). The parent's assessment of the child's overall well-being and of the child's pain was measured on a visual analogue scale.

Results
The overall prevalence of articular hypermobility was 34% (106/ 311), with the median hypermobility score being 3 (interquartile range 1, 5). Although the hypermobility score of girls (median 3; interquartile range 2, 5) exceeded that of boys (median 2.5; interquartile range 0, 5), this difference was not statistically significant (p = 0.16). The level of hypermobile children's pain in the preceding weeks, as assessed by the parents, was comparable to that recorded in the non-hypermobile peers. There was a weak negative correlation between the hypermobility score and the age of the child (r = -0.14, p=0.01). All instrument scores were comparable between hypermobile and non-hypermobile subjects, with the sole exception of a borderline significant greater impairment of the Role/ social limitations-physical subscale of the CHQ in the hypermobile group. The hypermobility score was not correlated with any instrument score.

Conclusions
The presence of joint hypermobility does not affect the functional ability and the physical and psychosocial well being of otherwise healthy children. These results suggest that the physical functioning in everyday life and the general health status of hypermobile children are not impaired.

Key words
Joint hypermobility, functional ability, health related quality of life.

Please address correspondence and reprint requests to: Angelo Ravelli, MD, Pediatria II, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genova, Italy.
E-mail: angeloravelli@ospedale-gaslini.ge.it