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      Developmental Coordination Disorder and Joint Hypermobility in Childhood: A Narrative Review

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          Abstract

          Children with developmental coordination disorder (DCD) and joint hypermobility could present an overlap of symptoms and motor functional difficulties. The link between these two clinical conditions has not yet been clarified. Recent studies reported a high incidence (30–50%) of motor delay in children who are referred to hypermobility and of enhanced joint hypermobility in children with DCD. The aim of this study was to provide a critical review of the literature outlining the association between DCD or limited motor performance and joint hypermobility. Studies were eligible for inclusion if they were written in English and human-based. All the studies were first selected, looking for the presence of a clinical association between developmental coordination disorder or motor performance and hyperlaxity and reporting details of outcome. After a review of the full texts, 16 articles for a total of 1898 children met the inclusion criteria. In general, there was evidence of a higher incidence of motor delay or DCD in children who are referred to hypermobility and of enhanced joint hypermobility in children with DCD with similar range of functional difficulties. These results could influence the way to support children with rehabilitation and the type of intervention according to the prevalence of one of the two conditions.

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          Most cited references36

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          European Academy for Childhood Disability (EACD): recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version).

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            Associations between objectively assessed physical activity and indicators of body fatness in 9- to 10-y-old European children: a population-based study from 4 distinct regions in Europe (the European Youth Heart Study).

            The rising prevalence of obesity in children may be due to a reduction in physical activity (PA). Our aim was to study the associations of objectively measured PA volume and its subcomponents with indicators of body fatness. A cross-sectional study of 1292 children aged 9-10 y from 4 distinct regions in Europe (Odense, Denmark; the island of Madeira, Portugal; Oslo; and Tartu, Estonia) was conducted. PA was measured by accelerometry, and indicators of body fatness were the sum of 5 skinfold thicknesses and body mass index (BMI; in kg/m(2)). We examined the associations between PA and body fatness by using general linear models adjusted for potential confounding variables. After adjustment for sex, study location, sexual maturity, birth weight, and parental BMI, time (min/d) spent at moderate and vigorous PA (P = 0.032) and time (min/d) spent at vigorous PA were significantly (P = 0.015) and independently associated with body fatness. Sex, study location, sexual maturity, birth weight, and parental BMI explained 29% (adjusted R(2) = 0.29) of the variation in body fatness. Time spent at vigorous PA explained an additional 0.5%. Children who accumulated 2 h/d. The accumulated amount of time spent at moderate and vigorous PA is related to body fatness in children, but this relation is weak; the explained variance was <1%.
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              Loss of proprioception produces deficits in interjoint coordination.

              1. We analyzed the performance of a simple pantomimed gesture in 2 patients with large-fiber sensory neuropathy and 11 control subjects to determine how proprioceptive deafferentation disrupts unconstrained multijoint movements. Both patients had near-total loss of joint position, vibration, and discriminative touch sensation in the upper extremities. Muscle strength remained intact. 2. Subjects performed a gesture similar to slicing a loaf of bread. In this gesture, the hand first moves outward from the body, reverses direction sharply, and then moves back toward the body. Accurate performance requires precise coordination between the shoulder and elbow joints during movement reversals. Movements were performed under two conditions: with eyes open and with eyes closed. Three dimensional shoulder, elbow, wrist, and hand trajectories were recorded on a WATSMART system. 3. When control subjects performed the gesture with their eyes closed, their wrist trajectories were relatively straight and individual cycles of motion were planar. Movements reversed direction sharply, such that outward and inward portions of the wrist path were closely aligned. Corresponding to this spatial profile, the reversals in movement direction at the shoulder joint, from flexion to extension, and at the elbow joint, from extension to flexion, were synchronous. 4. In contrast, when deafferented patients performed the gesture with their eyes closed, their wrist trajectories were highly curved and individual cycles were severely nonplanar. The wrist paths showed a characteristic anomaly during the reversal in movement direction, when elbow joint movement became transiently locked. Correspondingly, the movement reversals at the shoulder and elbow joints were severely temporally decoupled. 5. When patients were able to view their limbs during performance of this gesture there was significant improvement in the linearity and planarity of movements. However, the patients remained unable to synchronize the movements at the shoulder and elbow joints to produce spatially precise wrist paths. 6. We conclude that loss of proprioception disrupts interjoint coordination and discuss the hypothesis that this interjoint coordination deficit results from a failure to control the interaction forces that arise between limb segments during multijoint movements.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Children
                Children
                MDPI AG
                2227-9067
                July 2022
                July 07 2022
                : 9
                : 7
                : 1011
                Article
                10.3390/children9071011
                bb1a7153-9d36-4a55-9aa4-f82815109915
                © 2022

                https://creativecommons.org/licenses/by/4.0/

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