Elsevier

The Journal of Pediatrics

Volume 158, Issue 1, January 2011, Pages 119-123.e4
The Journal of Pediatrics

Original Article
Beighton Score: A Valid Measure for Generalized Hypermobility in Children

https://doi.org/10.1016/j.jpeds.2010.07.021Get rights and content

Objective

To evaluate the validity of the Beighton score as a generalized measure of hypermobility and to measure the prevalence of hypermobility and pain in a random population of school age children.

Study design

Prospective study of 551 children attending various Dutch elementary schools participated; 47% were males (258) and 53% (293) females, age range was 6 to 12 years. Children's joints and movements were assessed according to the Beighton score by qualified physiotherapists and by use of goniometry measuring 16 passive ranges of motion of joints on both sides of the body.

Results

More than 35% of children scored more than 5/9 on the Beighton score. Children who scored high on the Beighton score also showed increased range of motion in the other joints measured. Moreover 12.3% of children had symptoms of joint pain, and 9.1% complained of pain after exercise or sports. Importantly, this percentage was independent of the Beighton score. There were no significant differences in Beighton score for sex in this population.

Conclusion

The Beighton score, when goniometry is used, is a valid instrument to measure generalized joint mobility in school-age children 6 to 12 years. No extra items are needed to improve the scale.

Section snippets

Standardized Beighton Score Protocol

All the items were described and visualized with photos. Cutoff points for declaring an item as positive or negative were included (Appendix). Goniometry was used to measure the passive bilateral dorsiflexion of the fifth metacarpophalangeal joint and the passive bilateral hyperextension of the elbow and knee.

Standardized Joint Mobility Protocol

To obtain a reliable impression of overall joint mobility, an extended “standardized joint mobility protocol” (SJP) was developed. This describes test position, positioning of the

Results

In this random sample, 9.1% of the children scored 7 or more out of a possible 9 points on the Beighton score, and 35.6% scored 5 or more (Table III). Complaints of pain in joints, muscles, or ligaments were quite common. Overall, 13.3%, 12.8%, and 4.1% of participants cited this in respective Beighton score bands 1, 2 and 3. Pain after exercise or sport was reported for 8.8%, 9.6%, and 10% of the children, in bands 1, 2, and 3, respectively. These percentages were not significantly different

Discussion

The Beighton score is a valid measure for generalized joint hypermobility in children, on the basis of the detailed analysis of the ranges of motion of all major joints. Although the Beighton score covers a sample of joints, it was shown that increased mobility is present in other joints not covered. Pain over a period of time or after exercise does not seem to be valid extra information in hypermobility related complaints in children under 13 years. This concurs with the study by El-Metwally

References (23)

  • D.G.A. Rikken-Bultman et al.

    Hypermobility in two Dutch school populations

    Eur J Obstet Gynecol Reprod Biol

    (1997)
  • P. Beighton et al.

    Articular mobility in an African population

    Ann Rheum Dis

    (1973)
  • A.K. El Garf et al.

    Hypermobility among Egyptian children: prevalence and features

    J Rheumatol

    (1998)
  • C.C. Seow et al.

    A study of joint mobility in a normal population

    Ann Acad Med Singapore

    (1999)
  • Ű Seçkin et al.

    The prevalence of joint hypermobility among high school students

    Rheumatol Int

    (2005)
  • A. Jansson et al.

    General joint laxity in 1845 Swedish school children of different ages: age-and gender-specific distributions

    Acta Paediatr

    (2004)
  • A. Qvindesland et al.

    Articular hypermobility in Icelandic 12-years olds

    Rheumatology

    (1999)
  • F.N. Birrell et al.

    High Hypermobility of joint laxity in West Africans

    Br J Rheumatology

    (1994)
  • Z.S. Al-Rawi et al.

    Joint mobility among university students in Iraq

    Br J Rheumatology

    (1985)
  • L. Remvig et al.

    Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    J Rheumatology

    (2007)
  • J.H. Kirk et al.

    The hypermobility syndrome

    Ann Rheum Dis

    (1967)
  • Cited by (262)

    View all citing articles on Scopus

    The authors declare no conflicts of interest.

    View full text