title: Passive anterior tibial translation in women with and without joint hypermobility: an exploratory study.
abstract: OBJECTIVE
  Generalized joint hypermobility (GJH) is a frequent entity, which is still not fully understood. Symptoms associated with GJH are musculoskeletal disorders, decreased balance, impaired proprioception and chronic pain. The purpose of this study was to compare the passive anterior tibial translation (TT) in terms of distance and corresponding force between normomobile (NM) and hypermobile (HM) as well as between NM, symptomatic (HM-s) and asymptomatic (HM-as) hypermobile women.
  
  
  METHODS
  A total of 195 women, 67 NM and 128 HM, whereof 56 were further classified as HM-s and 47 as HM-as, participated in this study. Passive TT was measured using an adapted Rolimeter. A manual traction force was applied and the distance of the translation measured. For the analysis, maximal translation (TTmax) and the respective force as well as the distance at 40N (TTF40) and 80N (TTF80) traction force were determined. The NM and HM groups were compared using independent samples t-tests, whereas the NM, HM-s and HM-as groups were compared using one-way analyses of variance with Tukey post hoc tests (significance level P ≤ 0.05).
  
  
  RESULTS
  Comparisons revealed higher values for the variables TTmax, TTF40 and TTF80 in the HM compared to the NM group. In addition, TTmax and TTF80 were found to be higher in the HM-s compared to the NM group.
  
  
  CONCLUSIONS
  HM women showed significantly higher TT distances, which were even more accentuated in those having symptoms. The findings point toward less passive stability of the knee joint and thus maybe a need of higher muscle activation in order to stabilize the joint.
authors.affiliation: Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Stettler
authors.affiliation: Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.|Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland.
authors.forename: Gere
authors.initials: G
authors.lastname: Luder
authors.affiliation: Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schmid
authors.affiliation: Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Mueller Mebes
authors.affiliation: Inselspital, Department of Physiotherapy, Bern University Hospital, Bern, Switzerland.
authors.forename: Ursula
authors.initials: U
authors.lastname: Stutz
authors.affiliation: Osteo Rheuma Bern, Zentrum für muskuloskelettale Medizin, Bern, Switzerland.
authors.forename: Hans-Rudolf
authors.initials: HR
authors.lastname: Ziswiler
authors.affiliation: Health Division, Discipline of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Radlinger
mesh_terms: D000293:Adolescent; D000328:Adult; D058070:Asymptomatic Diseases; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000503:physiopathology*; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology*; D016059:Range of Motion, Articular; D012737:Sex Factors; D016037:Single-Blind Method; D013977:Tibia / Q000503:physiopathology*; D055815:Young Adult
keywords: benign generalized joint hypermobility; joint stabilization; passive tone; tibia translation