CoChat
Sign Up
PreprintCited by 4Connective tissue disorders researchMusculoskeletal pain and rehabilitationOral and gingival health research

A Systematised Review of the Beighton Score Compared with Other Commonly Used Measurement Tools for Assessment and Identification of Generalised Joint Hypermobility (GJH)

Open access
Alexander, Malini·2022·medRxiv
DOI 10.1101/2022.04.25.22274226
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Objective: A systematised review compared validity and reliability of the Beighton Score to those of other commonly used scores for identification of generalised joint hypermobility (GJH) Methods: Inclusion criteria: English language, studies on humans, all types of study designs, publications in academic journals, publications from the year two thousand onwards, publications in print and theses. Exclusion criteria: studies not in English, studies measuring single joints only, studies published before the year 2000, cadaveric studies, papers with only abstracts available. An electronic literature search was undertaken of Pub Med/MEDLINE, Embase, Scopus, Cochrane Database, SPORT Discus, Pedro databases, followed by a manual search. The final review included 73 papers. The PRISMA (2021) COSMIN (2010) guidelines and CASP (2019) criteria were used to evaluate methodological quality and bias. Results: The Beighton Score’s Intra-rater and inter-rater reliability ranged between ICC 0.74-0.99 and ICC 0.72-0.98 respectively. The BS has reasonable intra-rater and inter-rater reliability, however validity cannot be accurately determined as incorporation bias was identified as an issue in study methodology, not previously identified in the literature. Conclusion: Paucity of data prevented accurate assessment of other scoring systems. Urgent research is required to clarify these issues and compare the BS to other tests. No source of funding was received in in undertaking this review. This review was not registered.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1101/2022.04.25.22274226

Cites

85 of 105 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 38

  1. Aslan, U., Çelik, E., Cavlak, U., Akdağ, B., (2006) 'Evaluation of interrater and intrarater reliability of Beighton and Horan Joint Mobility Index', Fizyoterapi Rehabilitasyon, 17(3), pp. 113-119. Available at: https://www.researchgate.net/publication/287350205_Evaluation_of_interrater_and_intrarater_reliability_of_Be ighton_and_Horan_Joint_Mobility_Index (Accessed: 19 December 2021)
  2. Aslam, S., Emmanuel, P. (2010) 'Formulating a researchable question: A critical step for facilitating good clinical research' Indian journal of sexually transmitted diseases and AIDS, 31(1), pp. 47-50. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140151/ (Accessed: 21 December 2021)
  3. Balshem, H., Stevens, A., Ansari, M., Norris, S., Kansagara, D., Shamliyan, T., Chou, R., Chung, M., Moher, D., Dickersin, K., (2013) 'Finding Grey Literature Evidence and Assessing for Outcome and Analysis Reporting Biases When Comparing Medical Interventions: AHRQ and the Effective Health Care Program, Methods Guide for Effectiveness and Comparative Effectiveness Reviews', Agency for Healthcare Research and Quality (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK174882/ (Accessed: 16 December 2021)
  4. Brazzaventre, C., Celletti, C., Gobattoni, P., Santilli, V., Camerota, F., (2013) 'The Ehlers-Danlos syndrome: hystory of a clinical hendiadys', Medicina nei Secoli, 25(2), pp. 491-501. Available at: https://pubmed.ncbi.nlm.nih.gov/25807780/ (Accessed: 19 December 2021)
  5. Cattalini, M., Khubchandani, R., Cimaz, R., (2015) 'When flexibility is not necessarily a virtue: a review of hypermobility syndromes and chronic or recurrent musculoskeletal pain in children', BMC Paediatric Rheumatology, Vol 13:4, Pp 1-15. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596461/#__ffn_sectitle (Accessed: 11 December 2021)
  6. Cooper, D.J., Scammell, B.E., Batt, M.E., Palmer, D., (2018) 'Development and validation of self-reported line drawings of the modified Beighton score for the assessment of generalised joint hypermobility', BMC Medical Research Methodology, 18(11), pp. 1-8. Available at: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-017-0464-8#citeas (Accessed: 12 December 2021) · DOI
  7. De Groot, J., (2011) 'Verification problems in diagnostic accuracy studies: consequences and solutions', BMJ, 343, pp. 1-9. Available at: https://www.bmj.com/content/343/bmj.d4770.long (Accessed: 23 December 2021)
  8. Deeks, J., Higgins, J., Altman, D., (editors), (2021b) Chapter 10: Analysing data and undertaking meta-analyses, In: Cochrane Handbook for Systematic Reviews of Interventions, Version 6.2. Cochrane Training. Available at: https://training.cochrane.org/handbook/current/chapter-10 (Accessed: 12 December 2021)
  9. Desfor, F., (2003) 'Assessment of Joint Hypermobility in Dancers', Journal of Dance Science & Medicine, 7(1), pp. 17-23. Available at: https://www.ingentaconnect.com/content/jmrp/jdms/2003/00000007/00000001/art00003 (Accessed: 11 December 2021)
  10. Farmer, A., Douthwaite, H., Gardiner, S., Aziz, Q., Grahame R. (2010) 'A novel in vivo skin extensibility test for joint hypermobility', Journal of Rheumatology, 37(7) pp. 1513-8.
  11. Foley, C., Killeen, O., (2019) 'Musculoskeletal anomalies in children with Down syndrome: an observational study', Archives of Disease in Childhood, 104(5), pp 482-487. Available at: https://pubmed.ncbi.nlm.nih.gov/30472668/ (Accessed: 11 December 2021)
  12. Hamonet, C., Brock, I., (2015) 'Joint mobility and Ehlers-Danlos syndrome (EDS), new data based on 232 cases', Journal of Arthritis, 4(148), pp. 1-5. Available at: http://claude.hamonet.free.fr/eng/eds_joint-mobility.htm (Accessed: 12 December 2021)
  13. Huddad., C., Rosno, J., Prasad, V., (2013) 'When Research Evidence is Misleading', AMA Journal of Medical Ethics, 15(1), pp. 29-33. Available at: https://journalofethics.ama-assn.org/article/when-research-evidence- misleading/2013-01 (Accessed: 21 December 2021)
  14. Izatt, M.T., Bateman, G.R., Adam, C.J., (2012) 'Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis', Scoliosis, 7, pp. 14-22. Available at: https://doi.org/10.1186/1748-7161-7-14 (Accessed: 16 December 2021) · DOI
  15. Jha, B., Ross, M., Reeves, S., Couzens, G., Peters, S., (2015) 'Measuring thumb range of motion in first carpometacarpal joint arthritis: The inter-rater reliability of the Kapandji Index versus goniometry, Hand Therapy, 2(21), pp 45-53. Available at: https://www.researchgate.net/publication/284175959_Measuring_thumb_range_of_motion_in_first_carpometac arpal_joint_arthritis_The_inter-rater_reliability_of_the_Kapandji_Index_versus_goniometry (Accessed: 22 December 21)
  16. Jobling, R., D'Souza, R., Baker, N., Lara-Corrales, I., Mendoza-Londono, R., Dupuis, L., Savarirayan, R., Ala- Kokko, L., Kannu, P., (2014) 'The collagenopathies: review of clinical phenotypes and molecular correlations', Current Rheumatology Reports, 16(1) pp. 394-407. Available at: https://www.researchgate.net/publication/259336349_The_Collagenopathies_Review_of_Clinical_Phenotypes_ and_Molecular_Correlations (Accessed: 11 December 2021)
  17. Junge, T., Jespersen, E., Wedderkopp, N. Juul-Kristensen, B., (2013) 'Inter-tester reproducibility and inter- method agreement of two variations of the Beighton test for determining Generalised Joint Hypermobility in primary school children', BMC Pediatrics, 13(214), pp. 1-8. Available at: https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-13-214#citeas (Accessed: 12 December 2021) · DOI
  18. Juul-Kristensen, B., Schmedling, K., Rombaut, L., Lund, H., Engelbert, R.H.H., (2017) 'Measurement properties of clinical assessment methods for classifying generalized joint hypermobility-A systematic review', American Journal of Medical Genetics Part C Seminars in Medical, 175, pp. 116-147. Available at: https://doi.org/10.1002/ajmg.c.31540. (Accessed: 11 December 2021) · DOI · Paper page
  19. Keller, M.C., Hurschler, C., Schwarze, M., (2021) 'Experimental evaluation of precision and accuracy of RSA in the lumbar spine', European Spine Journal, 30, pp. 2060-2068. Available at: https://doi.org/10.1007/s00586-020- 06672-5 (Accessed: 16 December 2021) · DOI
  20. Korovessis, P., Petsinis, G., Papazisis, Z., Baikousis, A., (2001) 'Prediction of Thoracic Kyphosis Using the Debrunner Kyphometer', Journal of Spinal Disorders, 14, pp. 67-72. Available at: https://doi.org/10.1097/00002517-200102000-00010 (Accessed: 16 December 2021) · DOI
  21. Kottner, J., Audige, L., Brorson, S., Donner, A., Gajewski, B., Hrobjartsson, A., Roberts, C., Shoukri M, Streiner DL., (2011) 'Guidelines for reporting reliability and agreement studies (GRRAS) were Proposed', International Journal of Nursing Studies 48, pp. 661-71. Available at: https://pubmed.ncbi.nlm.nih.gov/21514934/ (Accessed: 20 December 2021)
  22. Kulik., O., Gebska., M., (2018) 'Comparison of Beighton score and Brighton Criterion in order to diagnose joint hypermobility in children', Journal of Education, Health and Sport, 8(5), pp. 133-148. Available at: http://ojs.ukw.edu.pl/index.php/johs/article/view/5472 (Accessed: 12 December 2021)
  23. Lidova, N., (2014), Natyashastra, Oxford Bibliographies. Available at: https://www.oxfordbibliographies.com/view/document/obo-9780195399318/obo-9780195399318-0071.xml (Accesssed: 19 December 2021)
  24. Lucas, NP., Macaskill, P., Irwig, L., Bogduk N., (2010) 'The development of a quality appraisal tool for studies of diagnostic reliability (QAREL)', Journal of Clin Epidemiology, 63, pp. 854-61. Available at: https://pubmed.ncbi.nlm.nih.gov/20056381/ ( Accessed: 20 December 2021)
  25. Lubberts, B., Guss, D., Vopat, B.G., Johnson, A.H., van Dijk, C.N., Lee, H., DiGiovanni, C.W., (2020) 'The arthroscopic syndesmotic assessment tool can differentiate between stable and unstable ankle syndesmoses' Knee Surgery, Sports Traumatology, Arthroscopy, 28, pp. 193-201. Available at: https://doi.org/10.1007/s00167-018- 5229-3 (Accessed: 15 December 2021) · DOI
  26. Macdonell, A., (1917), A Vedic Reader for Students, Containing Thirty Hymns of the Rigveda in the original Samhita and Pada Texts, with Transliteration, Translation, Explanatory Notes, Introduction, Vocabulary, Oxford: Clarendon Press, UK. Available at: https://oll.libertyfund.org/title/macdonell-a-vedic-reader-for-students (Accessed: 19 December 2021)
  27. Moraes, D., Baptista, C., Crippa, J., Louzada-Junior, P., (2011) 'Translation into Brazilian Portuguese and validation of the five-part questionnaire for identifying hypermobility, Revista Brasileira de Reumatologia, (1), pp. 53-69. Available at: https://pubmed.ncbi.nlm.nih.gov/21412606/. (Accessed: 12 December 2021)
  28. Morishita, K., Petty, R., (2011) 'Musculoskeletal Manifestations of Mucopolysaccharidoses', Rheumatology, 50, 5, pp. 19-25. Available at: https://doi.org/10.1093/rheumatology/ker397 (Accessed: 11 December 2021) · DOI
  29. Mourcou, Q., Fleury, A., Diot, B., Franco, C., Vuillerme, N., (2015) 'Mobile Phone-Based Joint Angle Measurement for Functional Assessment and Rehabilitation of Proprioception', BioMed Research International, 2015, pp. 1-15. Available at: https://doi.org/10.1155/2015/3 (Accessed: 16 December 2021) · DOI
  30. Patel, N., Riddlestone, P., Gunalan, R., Gough, A., Metcalfe, J., Holroyd, B., (2017) 'Reliability of Beighton's Score in a Pediatric Population', International Journal of Paediatric Orthopaedics, 3(1), pp. 9-11. Available at: http://ijpoonline.com/reliability-of-beightons-score-in-a-pediatric-population/ (Accessed: 22 June 2021)
  31. Raff, M., Byers, P., (1996) 'Joint Hypermobility Syndromes', Current Opinions in Rheumatology. 1996 Sep;8(5), pp. 459-66. Available at: https://pubmed.ncbi.nlm.nih.gov/8941450/ (Accessed: 11 December 2021)
  32. Russek, L., Stott, P., Simmonds, J., (2019) 'Recognizing and Effectively Managing Hypermobility-Related Conditions', Physical Therapy, 99(9), pp. 1189-1200. Available at: https://pubmed.ncbi.nlm.nih.gov/31158283/ (Accessed: December 2021)
  33. Sanders, S., Doust, J., Glasziou, P., (2015) 'A systematic review of studies comparing diagnostic clinical prediction rules with clinical judgment', PLoS One, 10(6), pp. 1-25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454557/ (Accessed: 23 December 2021)
  34. Sirajudeen, M., Waly, M., Alqahtani, M., Alzhrani, M., Aldhafiri, F., Muthusamy, H., Unnikrishnan, R., Saibannavar, R., Alrubaia, W., Nambi, G., (2020) 'Generalized joint hypermobility among school-aged children in Majmaah region', 11;8, pp1-13. Available at: https://pubmed.ncbi.nlm.nih.gov/32864212/ (Accessed: 11 December 2021)
  35. Skwiot, M., Śliwiński, G., Milanese, S., Śliwiński, Z., (2019) 'Hypermobility of joints in dancers', Plos One, 14(2), Pp 1-13. Available at: https://pubmed.ncbi.nlm.nih.gov/30794600/ (Accessed: 11 December 2021)
  36. Sobhani-Eragi, A., Motalebi, M., Sarreshtedari, S., Molazem-Senandaji, B., Hasanlu, Z., (2021) 'Prevalence of joint hypermobility in children and adolescents: A systematic review and meta-analysis', Journal of Research in Medical Sciences, 25(104), pp.1-8 . Available at: https://www.jmsjournal.net/article.asp?issn=1735- 1995;year=2020;volume=25;issue=1;spage=104;epage=104;aulast=Sobhani%2DEraghi (Accessed: 21 December 2021)
  37. Werner, K., (1977) 'Yoga and the Ṛg Veda: An Interpretation of the Keśin Hymn (RV 10, 136)', Religious Studies, 13(3), pp. 289-302. Available at: https://www.academia.edu/19561860/Yoga_and_the_Rg_Veda_An_Interpretation_of_the_Ke%C5%9Bin_Hym n_RV_10_136_?auto=download (Accessed: 19 December 2021)
  38. Zhang, M., McDaid, A., Zhang, S., Zhang, Y., Xie, S.Q., (2019) 'Automated robot-assisted assessment for wrist active ranges of motion', Medical Engineering and Physics, 71, pp. 98-101. Available at: https://doi.org/10.1016/j.medengphy.2019.07.003 (Accessed: 15 December 2021) · DOI

Cited by

Sorted by citations

Related

Authors
Alexander, M.
Affiliations
University of South Wales (GB)
Corresponding author
Alexander, Malini
Venue
medRxiv
Publisher
openRxiv
Published
2022-04-27
DOI
10.1101/2022.04.25.22274226
OpenAlex
W4225108140
Cited by
4
References
85
Citations by year
2026: 1 · 2025: 1 · 2024: 2
Type
posted content
Language
en
Open access
Licence
cc-by-nc-nd
Locations
medRxiv (acceptedVersion, cc-by-nc-nd)
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
Beighton score, generalized joint hypermobility, measurement validity, measurement reliability, intra-rater reliability, inter-rater reliability

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review