• 1

    Hudson N. Starr MR. Esdaile JM. et al: Diagnostic associations with hypermobility in rheumatology patients. Br J Rheumatol 34: 1157, 1995.

  • 2

    Bulbena A. Aqulló A. Pailhez G. et al: Is joint hypermobility related to anxiety in a nonclinical population also? Psychosomatics 45: 432, 2004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3

    De Inocencio J. Ocaña I. Benito L. Laxitud articular: prevalencia y relación con dolor musculoesquelético. An Pediatr (Barc) 61: 162, 2004.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4

    McCormack M. Briggs J. Hakim A. et al: Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol 31: 173, 2004.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Bravo J. Significado e importancia de estudiar a las personas con hiperlaxitud articular. Rev Chil Reumatol 24: 4, 2008.

  • 6

    Menéndez FM. De la laxitud a la hipermovilidad articular. Rev Cuba Reumatol 7: 1, 2005.

  • 7

    Bird HA. Joint hypermobility. Musculoskeletal Care 5: 4, 2007.

  • 8

    Bridges AL. Smith E. Reid J. Joint hypermobility in adults referred to rheumatology clinics. Ann Rheum Dis 51: 793, 1992.

  • 9

    Bravo J. Importancia de la hipermovilidad articular como causa frecuente de morbilidad, no sólo músculo–esquelética, sino también sistémica: criterios diagnósticos. Rev Chil Reumatol 19: 33, 2003.

    • Search Google Scholar
    • Export Citation
  • 10

    Rikken-Bultman DG. Wellink L. van Dongen PW. Hypermobility in two Dutch school populations. Eur J Obstet Gynecol Reprod Biol 73: 189, 1997.

  • 11

    Qvindesland A. Jónsson H. Articular hypermobility in Icelandic 12-year-olds. Rheumatology (Oxford) 38: 1014, 1999.

  • 12

    Seow CC. Chow PK. Khong KS. A study of joint mobility in a normal population. Ann Acad Med Singapore 28: 231, 1999.

  • 13

    Klemp P. Williams SM. Stansfield SA. Articular mobility in Maori and European New Zealanders. Rheumatology (Oxford) 41: 554, 2002.

  • 14

    Beynnon BD. Bernstein IM. Belisle A. et al: The effect of estradiol and progesterone on knee and ankle joint laxity. Am J Med Sports 33: 1298, 2005.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15

    Remvig L. Jensen DV. Ward RC. Are diagnostic criteria for general joint hypermobility and benign joint hypermobility syndrome based on reproducible and valid tests? a review of the literature. J Rheumatol 34: 798, 2007.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Yunchoy H. Síndrome de hipemovilidad articular. Rev Reumatol 17: 74, 2001.

  • 17

    Bulbena A. Duro JC. Porta M. et al: Clinical assessment of hypermobility of joints: assembling criteria. J Rheumatol 19: 115, 1992.

  • 18

    Murray KJ. Woo P. Benign joint hypermobility in childhood. Rheumatology (Oxford) 40: 489, 2001.

  • 19

    Van der Giessen LJ. Liekens D. Rutgers KJM. et al: Validation of Beighton score and prevalence of connective tissue signs in 773 Dutch children. J Rheumatol 28: 2726, 2001.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    March L. Silman A. Joint hyperlaxity: is there a case for screening? Br J Rheumatol 32: 91, 1993.

  • 21

    Bird HA. Joint hypermobility in children. Rheumatology (Oxford) 44: 703, 2005.

  • 22

    Grahame R. Pain, distress and joint hyperlaxity. Jt Bone Spine 67: 157, 2000.

  • 23

    Van Andel CJ. Roescher WB. Tromp MF. et al: Quantification of wrist joint laxity. J Am Soc Surg Hand 33: 667, 2008.

  • 24

    Mikkelsson M. Salminen K. Kautianen H. Joint hypermobility is not a contributing factor to musculoskeletal pain in pre–adolescents. J Rheumatol 23: 1963, 1996.

    • Search Google Scholar
    • Export Citation
  • 25

    Kamanli A. Sahin S. Ozgocmen S. et al: Relationship between foot angles and hypermobility scores and assessment of foot types in hypermobile individuals. Foot Ankle Int 25: 101, 2004.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Carter C. Wilkinson J. Persistent joint laxity and congenital dislocation of the hip. J Bone Joint Surg Br 46: 40, 1964.

  • 27

    Kirk JA. Ansell BM. Bywaters EGL. The hypermobility syndrome: musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis 26: 419, 1967.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Grahame R. Jenkins JM. Joint hypermobility: asset or liability? a study of joint mobility in ballet dancers. Ann Rheum Dis 31: 109, 1972.

  • 29

    Silverman L. Constine WH. Grahame R. Survey of joint mobility and in vivo skin elasticity in London schoolchildren. Ann Rheum Dis 34: 177, 1975.

  • 30

    Walker JM. Generalized joint laxity in Iglookik Eskimos and in island lake Amerindians. Hum Biol 47: 263, 1975.

  • 31

    Santos MC. Azevedo ES. Generalized joint hypermobility and black admixture in school children of Bahia, Brazil. Am J Phys Anthropol 55: 43, 1981.

  • 32

    Finsterbush A. Pogrund H. The hypermobility syndrome: musculoskeletal complaints in 100 consecutive cases of generalized joint hypermobility. Clin Orthop Relat Res 168: 124, 1982.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33

    Ekstrand J. Gilquist J. The frequency of muscle tightness and injuries in soccer players. Am J Sports Med 10: 75, 1982.

  • 34

    MacNeill-Shea S. Mezzomo JM. Relationship of ankle strength and hypermobility to squatting skills of children with Down syndrome. Phys Ther 65: 1958, 1985.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35

    Steele V. White J. Injure prediction in female gymnasts. Br J Sports Med 22: 31, 1986.

  • 36

    Francis H. March L. Terenty T. et al: Benign joint hypermobility with neuropathy: documentation and mechanism of tarsal tunnel syndrome. Br J Rheumatol 14: 577, 1987.

    • Search Google Scholar
    • Export Citation
  • 37

    Subramanyam V. Janaki KV. Joint hypermobility in south Indian children. Indian Pediatr 33: 771, 1996.

  • 38

    O'Connor K. Bragdon G. Baumhauer JF. Sexual dimorphism of the foot and ankle. Orthop Clin North Am 37: 569, 2006.

  • 39

    Lafuente G. Patrón rotador de la extremidad inferior: un nuevo parámetro exploratorio: relación con el hallux límitus [tesis], Departamento de Podología, Universidad de Sevilla, Seville, Spain, 2006.

    • Search Google Scholar
    • Export Citation
  • 40

    Lin CJ. Lai KA. Kuan TA. et al: Correlating factors and clinical significance of flexible flatfoot in preschool children. J Pediatr Orthop 21: 378, 2001.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41

    Ferrari J. Parslow C. Lim E. et al: Joint hypermobility: the use of a new assessment tool to measure lower limb hypermobility. Clin Exp Rheumatol 23: 413, 2005.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42

    Hirsch C. Hirsch M. John MT. et al: Reliability of the Beighton Hypermobility Index to determinate the general joint laxity performed by dentists. J Orofac Orthop 5: 342, 2007.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43

    Munuera PV. Domínguez G. Palomo I. et al: Effects of rearfoot-controlling orthotic treatment on dorsiflexion of the hallux in feet with abnormal subtalar pronation: a preliminary report. JAPMA 96: 283, 2006.

    • Search Google Scholar
    • Export Citation
  • 44

    Marnarch ML. Ramin KD. Ramsey PS. et al: Characterization of the relationship between joint laxity and maternal hormones in pregnancy. Obstet Gynecol 101: 331, 2003.

    • Search Google Scholar
    • Export Citation
  • 45

    Beighton P. Solomon L. Soskolne C. Articular mobility in an African population. Ann Rheum Dis 32: 413, 1973.

  • 46

    Kilgour G. McNair P. Stott NS. Intrarater reliability of lower limb sagittal range-of-motion measures in children with spastic diplegia. Dev Med Child Neurol 45: 391, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47

    Pandya S. Florence J. King WM. et al: Reliability of goniometric measurements in patients with Duchenne muscular dystrophy. Phys Ther 65: 1339, 1985.

  • 48

    Woodburn J. Video joint angle position analysis of the effects of subtalar joint position on maximum ankle joint dorsiflexion. J Br Podiatr Med 46: 1, 1991.

    • Search Google Scholar
    • Export Citation
  • 49

    Scharfbillig R. Scutter SD. Measurement of foot dorsiflexion: a modified Lidcombe template. JAPMA 94: 573, 2004.

  • 50

    Youdas JW. Bogard CL. Suman VJ. Reliability of goniometric measurements and visual estimates of ankle joint active range of motion obtained in a clinical setting. Arch Phys Med Rehabil 74: 1113, 1993.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51

    Rome K. Ankle joint dorsiflexion measurement studies: a review of the literature. JAPMA 86: 205, 1996.

  • 52

    Johanson MA. Cooksey A. Hillier C. et al: Heel lifts and the stance phase of gait in subjects with limited ankle dorsiflexion. J Athl Train 41: 159, 2006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53

    Pearsall AW. Kovaleski JE. Heitman RJ. et al: The relationships between instrumented measurements of ankle and knee ligamentous laxity and generalized joint laxity. J Sports Phys Fitness 46: 104, 2006.

    • Search Google Scholar
    • Export Citation
  • 54

    Mecagni C. Balance and ankle range of motion in community-dwelling women aged 64 to 87: a correlational study. Phys Ther 80: 1004, 2000.

  • 55

    Hall MG. Ferrell WR. Sturrock RD. et al: The effect of the hypermobility syndrome on knee joint propioception. Br J Rheumatol 34: 121, 1995.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 56

    Backer M. Kofoed H. Passive ankle mobility. J Bone Joint Surg Br 71: 696, 1989.

  • 57

    Azevedo ES. Santos MCN. Joint mobility in children: a population study. Acta Anthropog 6: 33, 1982.

  • 58

    Wilkierson RD. Mason MA. Differences in men's and women's mean ankle ligamentous laxity. Iowa Orthop J 20: 46, 2000.

  • 59

    Evans AM. Scutter SD. Sagittal plane range of motion of the pediatric ankle joint: a reliability study. JAPMA 96: 418, 2006.

  • 60

    Van Gheluwe B. Kirby KA. Roosen P. et al: Reliability and accuracy of biomechanical measurements of the lower extremities. JAPMA 92: 317, 2002.

    • Search Google Scholar
    • Export Citation
  • 61

    Jonson SR. Gross MT. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther 25: 253, 1997.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 62

    Simmonds JV. Keer RJ. Hypermobility and the hypermobility syndrome, part 2: assessment and management of hypermobility syndrome: illustrated via case studies. Man Ther 13: e1, 2008.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 63

    Wood PHN. Is hypermobility a discrete entity? Proc R Soc Med 64: 690, 1971.

  • 64

    Acasuso-Díaz M. Collantes-Estévez E. Sánchez P. Joint hyperlaxity and musculoligamentous lesions: study of a population of homogeneus age, sex and physical exertion. Br J Rheumatol 32: 120, 1993.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 65

    Verhoeven JJ. Tuinman M. van Dongan PW. Joint hypermobility in African non-pregnant nulliparous women. Eur J Obstet Gynecol Reprod Biol 82: 69, 1999.

Range of Ankle Dorsiflexion in a Group of Adults with Ligamentous Laxity

View More View Less
  • 1 Department of Podiatry, University of Seville, Seville, Spain.
  • | 2 Department of Nursing and Podiatry, University of Malaga, Malaga, Spain.
Restricted access

Background:

Ligamentous or joint laxity is a clinical entity characterized by increased joint mobility beyond the range of motion regarded as normal, and joint mobility is an effective indicator of the degree of laxity. We examined the influence of ligamentous laxity on the range of ankle dorsiflexion with the knee flexed and extended, comparing lax adults with a control (nonlax) group.

Methods:

The sample comprised 400 individuals: 200 in the control group (mean ± SD age, 32.49 ± 11.06 years) and 200 in the lax group (mean ± SD age, 29.82 ± 9.40 years). The Beighton criteria were applied to each participant to diagnose laxity or nonlaxity, and sex, age, and angle range of bilateral dorsiflexion with the knee extended and flexed were recorded.

Results:

The mean ± SD dorsiflexion range with the knee straight was 16.14° ± 5.29° left ankle and 21.21° ± 4.93° right ankle in the lax group and 12.94° ± 4.17° left ankle and 17.08° ± 4.40° right ankle in the control group. The respective values with the knee flexed were 15.84° ± 5.31° and 21.21° ± 4.80° in the lax group and 12.95° ± 3.95 and 17.23° ± 4.25° in the control group.

Conclusions:

In this sample, ankle dorsiflexion range in the lax group was 4° bigger than that in the control group in both knee positions.

Corresponding author: Salomon Benhamu-Benhamu, PhD, Department of Podiatry, University of Seville, C/ Avicena s/n, Seville 41009, Spain. (E-mail: benhamu@us.es)