title: Hypermobility is related with musculoskeletal pain in Indian school-children.
abstract: OBJECTIVE
  Hypermobility in children is common, however, its association with musculoskeletal pain remains controversial. There is lack of data from developing countries like India. This study aimed to look at the prevalence of musculoskeletal complaints and hypermobility in Indian school children.
  
  
  METHODS
  This was a cross-sectional, school-based study. Initially, a questionnaire regarding musculoskeletal pain was filled in by the schoolchildren (or their parents), and then verified. Three questions, including joint pain, back pain or ankle/foot pain for more than 1 week, were included for the purpose of this study. Subsequently, an abbreviated musculoskeletal examination (pGALS) was done and all children were checked for hypermobility (Beighton score). Odds ratios (with 95% confidence intervals) were calculated using contingency table (chi-square test) to examine the association of musculoskeletal pain with hypermobility (using different Beighton score cut-offs).
  
  
  RESULTS
  One thousand eight hundred and thirty-eight children were included (742 girls and 1096 boys), with mean age of 11.5±2.9 years. Joint pain was reported in 113 (6.1%), back pain in 52 (2.8%) and ankle/foot pain in 53 (2.9%). Prevalence of hypermobility was dependent on the definition used, varying from 816 children (44.4%) to 1081 (58.8%) when using the Beighton score ≥6 or ≥4, respectively. Odds ratio of having hypermobility (Beighton score ≥4) in children with joint pain, back and ankle pain was 4.2 (95%CI 2.5-7.2), 3.4 (95%CI 1.7-7.1) and 1.9 (95%CI 1.1-3.7), respectively.
  
  
  CONCLUSIONS
  We found that a large proportion of Indian school children had hypermobility. There was an association between the presence of joint, back or ankle/foot pain with hypermobility in Indian school children. This association was strongest when a Beighton score cut-off of 4 was used to define hypermobility.
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. boabuja@gmail.com.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Abujam
authors.forename: Amita
authors.initials: A
authors.lastname: Aggarwal
mesh_terms: D000293:Adolescent; D000367:Age Factors; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology*; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007593:Joint Instability / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D010147:Pain Measurement; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires