Date of Award

2005

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Susan H.N. Jeno

Keywords

Joint Instability; Postural Balance

Abstract

A significant percentage of Physical Therapy and Occupational Therapy students have been found to exhibit signs of systemic hypermobility. Hypermobility can be defined as joints displaying excessive range of movement. Balance is an integral aspect of the job tasks of Physical Therapists and Occupational Therapists and involves collaboration of muscles, joints, ligaments, and the proprioceptive input they collectively provide. The purpose of this study is to assess the effects of hyper mobility on static and dynamic balance in a population of Physical Therapy and Occupational Therapy students at the University of North Dakota.

Seventy nine physical therapy and occupational therapy students (60 females and 19 males) between the ages of 20-28 years voluntarily participated in the hypermobility screening portion of this study. All subjects were screened for hypermobility using the Beighton Scale for hypermobility. Twenty subjects were found to be hypermobile and were asked to further participate in a balance test on the NeuroCom® Balance Master(NBM), of these 20,19 were able to participate. Twelve subjects who were not found to exhibit hypermobility were randomly assigned to a control group and also performed tests on the NBM. Tests on the NBM included modified Clinical Test for Sensory Interaction on Balance (mCTSIB) and Limits of Stability (LOS) test which tested static and dynamic balance respectively.

The independent samples t-test was completed to determine the mean difference between the control group and the group of subjects with signs of hyper mobility. Statistical significance was set at a = .05 level.

Independent Samples t-test was used t6 analyze the results of the NBM tests. No significant difference was found between subjects in the control group (M=I.II, SD=0.36) and in the group displaying hypermobility (M=I.20, SD=0.26) for the mCTSIB foam eyes closed score, t(29)=-0.823, p=0.42. No significant difference was found between subjects in the control group (M=0.44, SD=0.10) and in the group displaying hypermobility (M=0.51, SD=0.09) for the mCTSIB composite score, t(29)=-1.95, p=0.06. No significant difference was found between subjects in the control group (M=81.25, SD=7.90) and in the group displaying hypermobility (M=79.95, SD=6.51) for the LOS end point excursion composite score, t(29)=0.50, p=0.62. No significant difference was found between subjects in the control group (M=91.75, SD=6.62) and subjects in the group displaying hypermobility (M=92.0, SD=3.59) for the LOS maximum excursion composite score, t(29)=-0.12, p=0.91. No significant difference was found between subjects in the control group (M=80.08, SD=3.60) and subjects in the group displaying hypermobility (M=79.05, SD=5.l4) for the LOS directional control composite score, t(29)=0.61, p=0.55. A significant difference was found between subjects with hypermobility of the upper extremities (M=0.98, SD=0.19) and in subjects with upper extremity, lower extremity, and trunk (M=1.26, SD=0.25) for the mCTSIB foam eyes closed score, t(17)= -2.09, p=0.05. A Mann Whitney U-test was used to determine if a mean difference existed between subjects with hypermobility in the upper extremities only (n=4) and subjects with hypermobility in the upper extremities, trunk, and lower extremities (n=15). The results indicate no significant difference between groups for LOS directional control composite score, U=29, p=0.92 with the sum of ranks equal to 39.00 for the upper extremity group and 151.00 for the trunk, upper extremity, and lower extremity group. A significant difference was found between groups for mCTSIB composite score, U=9.00, p=0.03 with the sum of ranks equal to 19 for the upper extremity group and 171 for the trunk, upper extremity, and lower extremity group.

Hypermobility does not appear to have an effect on static or dynamic balance in this population of Physical Therapy and Occupational Therapy students. More research is needed to assess the functional impacts ofhypermobility on balance.

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