The Lower Limb Assessment Score. This file contains the name, patient and therapist instructions and criteria for each of the 12 tests of the Lower Limb Assessment score as described by the original authors that developed this tool. (DOCX 17 kb

AJ Hakim

AM Evans

B Juul-Kristensen

B Smits-Engelsman

B Steinmann

B Tinkle

Cliffton Chan

DV Cicchetti

F Malfait

H Singh

J Ferrari

Kaitlin J. Meyer

L Remvig

Leslie L. Nicholson

LM Gannon

Luke Hopper

M Castori

P Beighton

P Klemp

R Grahame

R Taylor

T Junge

WG Hamilton

BMC Musculoskeletal Disorders

Background The Lower Limb Assessment Score (LLAS) has only been validated in a paediatric population. The aim of this study was to validate the use of the LLAS in an adult population by: i) evaluating its ability to discriminate between different extents of lower limb hypermobility, ii) establishing a cut-off score to identify lower limb hypermobility, and iii) determining if the LLAS is able to identify Generalised Joint Hypermobility (GJH).  Methods Participants were recruited across three groups representing varying degrees of hypermobility. They were assessed using the LLAS, Beighton score and clinical opinion. Pearson’s correlation coefficient and MANOVA were used to assess between-group differences in the LLAS. The cut-off score was determined using median and inter-quartile ranges and the Receiver Operator Characteristic Curve. The ability of the LLAS to identify GJH was assessed using percent agreement with clinical opinion.  Results One hundred twelve participants aged 18–40 years were recruited. The LLAS distinguished the control from the likely hypermobile and known hypermobile cohorts (both p \u3c 0.001), as well as the likely hypermobile from the known hypermobile cohort (p = 0.003). The LLAS cut-off score for identifying lower limb hypermobility was ≥7/12 with a specificity of 86% and sensitivity of 68%. The LLAS accurately identified those with GJH with high percentage agreement compared to clinical opinion across all cohorts (69–98%).  Conclusions The LLAS is a valid tool for identifying lower limb specific hypermobility and GJH in adults at a cut-off score of ≥7/12. It demonstrates excellent specificity and moderate sensitivity, and discriminates well between extents of hypermobility

Meyer, Kaitlyn J.

Chan, Cliffton

Hopper, Luke

Nicholson, Leslie L.

Research Online @ ECU

English

Identifying lower limb specific and generalised joint hypermobility in adults: validation of the Lower Limb Assessment Score

Abstract Background The Lower Limb Assessment Score (LLAS) has only been validated in a paediatric population. The aim of this study was to validate the use of the LLAS in an adult population by: i) evaluating its ability to discriminate between different extents of lower limb hypermobility, ii) establishing a cut-off score to identify lower limb hypermobility, and iii) determining if the LLAS is able to identify Generalised Joint Hypermobility (GJH). Methods Participants were recruited across three groups representing varying degrees of hypermobility. They were assessed using the LLAS, Beighton score and clinical opinion. Pearson’s correlation coefficient and MANOVA were used to assess between-group differences in the LLAS. The cut-off score was determined using median and inter-quartile ranges and the Receiver Operator Characteristic Curve. The ability of the LLAS to identify GJH was assessed using percent agreement with clinical opinion. Results One hundred twelve participants aged 18–40 years were recruited. The LLAS distinguished the control from the likely hypermobile and known hypermobile cohorts (both p < 0.001), as well as the likely hypermobile from the known hypermobile cohort (p = 0.003). The LLAS cut-off score for identifying lower limb hypermobility was ≥7/12 with a specificity of 86% and sensitivity of 68%. The LLAS accurately identified those with GJH with high percentage agreement compared to clinical opinion across all cohorts (69–98%). Conclusions The LLAS is a valid tool for identifying lower limb specific hypermobility and GJH in adults at a cut-off score of ≥7/12. It demonstrates excellent specificity and moderate sensitivity, and discriminates well between extents of hypermobility

Directory of Open Access Journals

The Beighton Score. This file contains the standardised criteria of the five tests involved in scoring of the Beighton in this study. (DOCX 19 kb

Kaitlin Meyer (4668172)

Cliffton Chan (4668169)

Luke Hopper (4668166)

Leslie Nicholson (4668163)

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Additional file 2: of Identifying lower limb specific and generalised joint hypermobility in adults: validation of the Lower Limb Assessment Score

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