# No association between joint hypermobility, musculoskeletal pain and neurodevelopmental problems in a school-based sample of 11-year-old children

## TL;DR

This study found no link between joint hypermobility and neurodevelopmental problems in 11-year-old children, unlike in adults.

## Contribution

The study provides the first evidence on GJH prevalence and its lack of association with NDPs in a school-based pediatric sample.

## Key findings

- No significant association was found between high Beighton scores and neurodevelopmental problems.
- The median Beighton score was low, with no gender differences observed.
- Weekly musculoskeletal pain was common (42%), but not strongly linked to hypermobility.

## Abstract

Adult cohorts with generalised joint hypermobility (GJH) report higher rates of neurodevelopmental problems (NDPs). However, the prevalence of GJH in community-dwelling children and its association with NDPs remains unexplored.

This study aimed to (a) assess the prevalence of GJH, (b) examine its link to musculoskeletal pain and (c) explore associations with NDPs in 11-year-old Swedish children.

An in-school study was conducted as part of the 4th grade health check-up. It included a structured physical examination using the Beighton score (range 0–9) and a comprehensive neurodevelopmental assessment based on behavioural ratings, maternal interviews, medical records and academic performance.

Of 348 eligible children from eight schools, 223 (64%) participated, with Beighton scores measured in 207 (59%). The median Beighton score was 1 (interquartile range 0–2), with no significant gender differences (Wilcoxon test, P = 0.17). A Beighton score of ≥6 approximated the 95th percentile in both sexes. No significant association was found between high Beighton scores and NDPs. Few children with GJH reported weekly pain, indicating a low prevalence of hypermobility spectrum disorders in this age group.

Our findings validate the age-specific Beighton score cut-off and suggest that GJH in children of this age is not linked to NDPs, differing from findings in adults. This may reflect developmental changes during puberty. Additionally, the high prevalence of weekly pain (42%) in the cohort warrants further investigation into its causes and impact.