Prevalence, associated disorders and treatment of joint hypermobility syndrome; A systematic review

Abstract

BACKGROUND: Joint hypermobility syndrome (JHS)-which was previously named benign JHS- is a condition in which there are musculoskeletal symptoms with generalized hypermobility without any associated connective tissue abnormality or congenital syndrome. METHODS: This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Article databases were reviewed in depth by two researchers blinded to each other. The quality of the articles was evaluated based on the QUADAS-2 tool. RESULTS: The overall prevalence of JHS was estimated to be 17.2 , this overall prevalence in boys was 17.9 and 24.2 in girls was determined. The main disorders associated with JHS included orthopedic disorders, the main of which were scoliosis, knee injuries, hip dysfunction, jaw dysfunction, and shoulder dysfunction. Among non-orthopedic underlying diseases, the most important underlying disorders included digestive disorders, vesicoureteral reflux, orthostatic tachycardia syndrome and anxiety disorders. The main therapeutic approaches offered to improve JHS included education, mindfulness and body stability training, exercise and physical therapy, psychological counseling, occupational therapy, transcutaneous electrical nerve stimulation, limb splinting, and foot orthosis. These approaches showed promise in managing musculoskeletal symptoms and psychological comorbidities, but evidence on extra-articular systemic symptoms was limited. CONCLUSION: JHS is a common disorder among children and adolescents, associated with both orthopedic and non-orthopedic disorders. Supportive treatments, physiotherapy, and occupational therapy appear effective for musculoskeletal and psychological symptoms, though their impact on extra-articular systemic symptoms remains unclear. Further research is needed to optimize diagnostic and therapeutic strategies.