Open Access Open Badges Research article

The functional consequences of Generalized Joint Hypermobility: a cross-sectional study

Mark C Scheper12*, Janneke E de Vries1, Birgit Juul-Kristensen3, Frans Nollet2 and Raoul hh Engelbert12

Author Affiliations

1 Amsterdam School of Health Professions, Education of Physiotherapy, Amsterdam, The Netherlands

2 Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

3 University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, Odense, Denmark

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BMC Musculoskeletal Disorders 2014, 15:243  doi:10.1186/1471-2474-15-243

Published: 21 July 2014



Generalized Joint Hypermobility (GJH) has been found to be associated with musculoskeletal complaints and disability. For others GJH is seen as a prerequisite in order to excel in certain sports like dance. However, it remains unclear what the role is of GJH in human performance. Therefore, the purpose of the study was to establish the association between GJH and functional status and to explore the contribution of physical fitness and musculoskeletal complaints to this association.


A total of 72 female participants (mean age (SD; range): 19.6 (2.2; 17-24)) were recruited among students from the Amsterdam School of Health Professions (ASHP) (n = 36) and the Amsterdam School of Arts (ASA), Academy for dance and theater (n = 36) in Amsterdam, The Netherlands. From each participant the following data was collected: Functional status performance (self-reported Physical activity level) and capacity (walking distance and jumping capacity: side hop (SH) and square hop (SQH)), presence of GJH (Beighton score ≥4), muscle strength, musculoskeletal complaints (pain and fatigue) and demographic characteristics (age and BMI).


GJH was negatively associated with all capacity measures of functional status. Subjects with GJH had a reduced walking distance (B(SE):-75.5(10.5), p = <.0001) and jumping capacity (SH: B(SE):-10.10(5.0), p = .048, and SQH: B(SE):-11.2(5.1), p = .024) in comparison to subjects without GJH, when controlling for confounding: age, BMI and musculoskeletal complaints. In participants with GJH, functional status was not associated with performance measures.


GJH was independently associated with lower walking and jumping capacity, potentially due to the compromised structural integrity of connective tissue. However, pain, fatigue and muscle strength were also important contributors to functional status.

Generalized Joint Hypermobility; Functional status; Dance; Pain