The Upper Limb Hypermobility Assessment Tool: A novel validated measure of adult joint mobility
Abstract
Background Existing measures of generalized joint hypermobility do not include commonly affected upper limb joints. Objective To evaluate the reliability of a novel clinically-applicable measure of upper limb joint mobility, its ability to discriminate between varying extents of hypermobility, identify generalized joint hypermobility, and to establish a cut-point for hypermobility classification. Design Validation of a diagnostic tool. Method Participants were sought from three groups - healthy controls, likely and known hypermobiles, and assessed using the Upper Limb Hypermobility Assessment Tool (ULHAT), Beighton score and clinical opinion. Pearson's correlation coefficient examined individual group and whole cohort relationships between upper limb hypermobility, age, gender and ethnicity. MANOVA investigated between-group differences in ULHAT scores. Median interquartile ranges and ROC Curve analysis identified the cut-off score for identification of upper limb hypermobility. Percent agreement with clinical opinion assessed the ability of the ULHAT to identify generalized joint hypermobility. Results 112 adult participants (mean age 24.3 ± 5.5years) across the three groups were assessed. Inter-rater reliability of the tool was high (ICC2,1 = 0.92). The cut-point was established at ≥7/12 (sensitivity 0.84, specificity 0.77, +LR 3.7, -LR 0.2). Upper limb hypermobility did not vary with age or ethnicity (both p > 0.12), but was greater in females (p Conclusions The 12-item UL…
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The Upper Limb Hypermobility Assessment Tool (ULHAT) is yet to be validated in children.
“In particular, the Upper Limb Hypermobility Assessment Tool (ULHAT) [15] (yet to be validated in children) and Lower Limb Assessment Score (LLAS) [16].”
From Pediatric joint hypermobility: a diagnostic framework and narrative review (2023) · cites this paper as [15]
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Pediatric joint hypermobility: a diagnostic framework and narrative review
Tofts, L. J., Simmonds, J., Schwartz, S. B., Richheimer, R. M., O’Connor, C., Elias, E., Engelbert, R., Cleary, K., Tinkle, B. T., Kline, A. D., et al. (2023) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-023-02717-2 · Cited by 74 · see citing works
“In particular, the Upper Limb Hypermobility Assessment Tool (ULHAT) [15] (yet to be validated in children) and Lower Limb Assessment Score (LLAS) [16].”
BackgroundLiaghat, B., Skou, S. T., Søndergaard, J., Boyle, E., Søgaard, K., & Juul-Kristensen, B. (2022) · British Journal of Sports Medicine · doi:10.1136/bjsports-2021-105223 · Cited by 27 · see citing works
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Simmonds, J. V. (2022) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2021.102465 · Cited by 21 · see citing works
Chan, C., Krahe, A., Lee, Y. T., & Nicholson, L. L. (2019) · Clinical Rheumatology · doi:10.1007/s10067-018-4296-7 · Cited by 18 · see citing works
Self-citation
- Authors
- Nicholson, L. L., & Chan, C.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Nicholson, Leslie L.
- Venue
- Musculoskeletal Science and Practice
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 35
- Pages
- 38-45
- ISSN
- 2468-7812 (ISSN-L)
- OpenAlex
- W2792955218
- Cited by
- 40
- References
- 11
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 9 · 2021: 4 · 2020: 6 · 2019: 1 · 2018: 1
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Musculoskeletal Science and Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Pharmacy › Oral and gingival health research
- Keywords
- generalized joint hypermobility, joint mobility assessment, Beighton score, cut-off values, inter-rater reliability, diagnostic tool validation
- MeSH terms
- Adult, Age Factors, Ehlers-Danlos Syndrome, Female, Humans, Joint Instability, Male, Prospective Studies, ROC Curve, Severity of Illness Index, Sex Factors, Reproducibility of Results, Multivariate Analysis, Case-Control Studies, Range of Motion, Articular, Upper Extremity, Young Adult
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