Joint hypermobility syndrome subclassification in paediatrics

A factor analytic approach

Verity Pacey, Roger D. Adams, Louise Tofts, Craig F. Munns, Leslie L. Nicholson

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To determine if exploratory factor analysis can identify subtypes comprising recognisable clinical patterns of the presenting signs and symptoms of children with joint hypermobility syndrome (JHS). Patients Eighty-nine children with JHS aged 6-16 years. Methods: Twelve tests comprising anthropometric, musculoskeletal and functional assessments were conducted. Signs, symptoms and family history were recorded. Exploratory factor analysis was performed, factor scores generated, and correlations calculated to identify associations. Results: Sixty-six percent of the variance in the score set could be accounted for by five JHS subtypes (Eigenvalues >1). Factor 1, 'joint affected' JHS, had loadings on multiple joint pain, recurrent joint instability and postural orthostatic hypotension symptoms, and factor scores were associated with worse pain (r=0.48, p<0.01), fatigue (r=-0.54, p<0.01) and reduced health-related quality of life (HRQOL) (r=-0.5, p<0.01). Factor 2, 'athletic' JHS, loaded on muscle endurance, balance and motor skill proficiency, and scores were associated with less fatigue (r=0.3, p<0.01) and better HRQOL (r=0.44, p<0.01). Factor 3, 'systemic' JHS, loaded on skin involvement, incontinence symptoms, bowel involvement and recurrent joint instability, and was associated with reduced HRQOL (r=-0.24, p=0.03). Factor 4, 'soft tissue affected' JHS, loaded on recurrent soft tissue injuries and reduced muscle length, and was associated with greater fatigue (r=-0.43, p<0.01) and reduced HRQOL (r=-0.44, p<0.0001). Factor 5, 'high BMI' JHS, had high loadings on body mass index (BMI) for age, muscle endurance and no gastrointestinal involvement, and was associated with higher pain (r=0.33, p<0.01). Conclusions: The presenting signs and symptoms of children with JHS can be summarised in five clinically recognisable subtypes.

Original languageEnglish
Pages (from-to)8-13
Number of pages6
JournalArchives of Disease in Childhood
Volume100
Issue number1
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Joint Instability
Pediatrics
Quality of Life
Signs and Symptoms
Fatigue
Orthostatic Hypotension
Muscles
Statistical Factor Analysis
Body Mass Index
Pain
Soft Tissue Injuries
Motor Skills
Arthralgia
Sports
Joints

Cite this

Pacey, Verity ; Adams, Roger D. ; Tofts, Louise ; Munns, Craig F. ; Nicholson, Leslie L. / Joint hypermobility syndrome subclassification in paediatrics : A factor analytic approach. In: Archives of Disease in Childhood. 2015 ; Vol. 100, No. 1. pp. 8-13.
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abstract = "Objective: To determine if exploratory factor analysis can identify subtypes comprising recognisable clinical patterns of the presenting signs and symptoms of children with joint hypermobility syndrome (JHS). Patients Eighty-nine children with JHS aged 6-16 years. Methods: Twelve tests comprising anthropometric, musculoskeletal and functional assessments were conducted. Signs, symptoms and family history were recorded. Exploratory factor analysis was performed, factor scores generated, and correlations calculated to identify associations. Results: Sixty-six percent of the variance in the score set could be accounted for by five JHS subtypes (Eigenvalues >1). Factor 1, 'joint affected' JHS, had loadings on multiple joint pain, recurrent joint instability and postural orthostatic hypotension symptoms, and factor scores were associated with worse pain (r=0.48, p<0.01), fatigue (r=-0.54, p<0.01) and reduced health-related quality of life (HRQOL) (r=-0.5, p<0.01). Factor 2, 'athletic' JHS, loaded on muscle endurance, balance and motor skill proficiency, and scores were associated with less fatigue (r=0.3, p<0.01) and better HRQOL (r=0.44, p<0.01). Factor 3, 'systemic' JHS, loaded on skin involvement, incontinence symptoms, bowel involvement and recurrent joint instability, and was associated with reduced HRQOL (r=-0.24, p=0.03). Factor 4, 'soft tissue affected' JHS, loaded on recurrent soft tissue injuries and reduced muscle length, and was associated with greater fatigue (r=-0.43, p<0.01) and reduced HRQOL (r=-0.44, p<0.0001). Factor 5, 'high BMI' JHS, had high loadings on body mass index (BMI) for age, muscle endurance and no gastrointestinal involvement, and was associated with higher pain (r=0.33, p<0.01). Conclusions: The presenting signs and symptoms of children with JHS can be summarised in five clinically recognisable subtypes.",
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Joint hypermobility syndrome subclassification in paediatrics : A factor analytic approach. / Pacey, Verity; Adams, Roger D.; Tofts, Louise; Munns, Craig F.; Nicholson, Leslie L.

In: Archives of Disease in Childhood, Vol. 100, No. 1, 2015, p. 8-13.

Research output: Contribution to journalArticle

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AU - Adams, Roger D.

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AU - Nicholson, Leslie L.

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N2 - Objective: To determine if exploratory factor analysis can identify subtypes comprising recognisable clinical patterns of the presenting signs and symptoms of children with joint hypermobility syndrome (JHS). Patients Eighty-nine children with JHS aged 6-16 years. Methods: Twelve tests comprising anthropometric, musculoskeletal and functional assessments were conducted. Signs, symptoms and family history were recorded. Exploratory factor analysis was performed, factor scores generated, and correlations calculated to identify associations. Results: Sixty-six percent of the variance in the score set could be accounted for by five JHS subtypes (Eigenvalues >1). Factor 1, 'joint affected' JHS, had loadings on multiple joint pain, recurrent joint instability and postural orthostatic hypotension symptoms, and factor scores were associated with worse pain (r=0.48, p<0.01), fatigue (r=-0.54, p<0.01) and reduced health-related quality of life (HRQOL) (r=-0.5, p<0.01). Factor 2, 'athletic' JHS, loaded on muscle endurance, balance and motor skill proficiency, and scores were associated with less fatigue (r=0.3, p<0.01) and better HRQOL (r=0.44, p<0.01). Factor 3, 'systemic' JHS, loaded on skin involvement, incontinence symptoms, bowel involvement and recurrent joint instability, and was associated with reduced HRQOL (r=-0.24, p=0.03). Factor 4, 'soft tissue affected' JHS, loaded on recurrent soft tissue injuries and reduced muscle length, and was associated with greater fatigue (r=-0.43, p<0.01) and reduced HRQOL (r=-0.44, p<0.0001). Factor 5, 'high BMI' JHS, had high loadings on body mass index (BMI) for age, muscle endurance and no gastrointestinal involvement, and was associated with higher pain (r=0.33, p<0.01). Conclusions: The presenting signs and symptoms of children with JHS can be summarised in five clinically recognisable subtypes.

AB - Objective: To determine if exploratory factor analysis can identify subtypes comprising recognisable clinical patterns of the presenting signs and symptoms of children with joint hypermobility syndrome (JHS). Patients Eighty-nine children with JHS aged 6-16 years. Methods: Twelve tests comprising anthropometric, musculoskeletal and functional assessments were conducted. Signs, symptoms and family history were recorded. Exploratory factor analysis was performed, factor scores generated, and correlations calculated to identify associations. Results: Sixty-six percent of the variance in the score set could be accounted for by five JHS subtypes (Eigenvalues >1). Factor 1, 'joint affected' JHS, had loadings on multiple joint pain, recurrent joint instability and postural orthostatic hypotension symptoms, and factor scores were associated with worse pain (r=0.48, p<0.01), fatigue (r=-0.54, p<0.01) and reduced health-related quality of life (HRQOL) (r=-0.5, p<0.01). Factor 2, 'athletic' JHS, loaded on muscle endurance, balance and motor skill proficiency, and scores were associated with less fatigue (r=0.3, p<0.01) and better HRQOL (r=0.44, p<0.01). Factor 3, 'systemic' JHS, loaded on skin involvement, incontinence symptoms, bowel involvement and recurrent joint instability, and was associated with reduced HRQOL (r=-0.24, p=0.03). Factor 4, 'soft tissue affected' JHS, loaded on recurrent soft tissue injuries and reduced muscle length, and was associated with greater fatigue (r=-0.43, p<0.01) and reduced HRQOL (r=-0.44, p<0.0001). Factor 5, 'high BMI' JHS, had high loadings on body mass index (BMI) for age, muscle endurance and no gastrointestinal involvement, and was associated with higher pain (r=0.33, p<0.01). Conclusions: The presenting signs and symptoms of children with JHS can be summarised in five clinically recognisable subtypes.

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