Sleep Characteristics in Infants With Joint Hypermobility

NCT ID: NCT07121179

Last Updated: 2025-09-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

54 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-08-15

Study Completion Date

2026-01-15

Brief Summary

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Joint hypermobility is defined as an increased range of motion in one or more joints compared to the normal range. The Beighton Scoring (BS) system is commonly used to distinguish individuals with generalized joint hypermobility from those without. Passive joint range of motion varies among infants, children, and adults. Since younger children exhibit greater joint mobility than older children and adults, age-specific revisions of the cut-off values are necessary for the diagnosis of Generalized Joint Hypermobility (GJH). To this end, a recent study suggested that children aged 12 to 60 months should be diagnosed with GJH if the BS is greater than 4.

Studies have shown that motor development in children with joint hypermobility is delayed during early childhood, although most children catch up with their peers before the age of two. Infants with joint hypermobility experience significant delays in both gross and fine motor development. Additionally, proprioceptive impairments have been identified in both children and adults with joint hypermobility. A study evaluating sensory processing skills in toddlers with GJH reported sensory processing difficulties compared to their non-GJH peers. A review of the literature reveals that GJH affects the musculoskeletal system, motor development, and sensory processing skills in infants; however, no studies have been found investigating sleep characteristics in infants with GJH. This study aims to investigate the sleep characteristics of term infants aged 6 to 9 months with GJH and to compare them with their non-GJH peers.

Detailed Description

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Ligamentous laxity and the resulting joint hypermobility are present in various conditions affecting children, such as Marfan syndrome and Ehlers-Danlos syndrome. However, in most cases, joint hypermobility is a limited condition referred to as Generalized Joint Hypermobility (GJH). GJH is defined as asymptomatic hypermobility in more than five joints. The Beighton Scoring (BS) system is commonly used to distinguish individuals with generalized joint hypermobility from those without. The BS system includes the following assessments: passive dorsiflexion of the fifth metacarpophalangeal joint, passive hyperextension of the elbow, passive hyperextension of the knee, passive apposition of the thumb to the flexor aspect of the forearm, and forward flexion of the trunk.

In children older than five years, a cut-off score of ≥6 is used to diagnose GJH. In adults up to 50 years of age, a score of ≥5 out of 9 indicates GJH, while a score of ≥4 out of 9 is considered positive for GJH in adults over 50 years.

Joint hypermobility can cause stability issues in the musculoskeletal system due to connective tissue laxity. This can trigger problems such as discomfort, restlessness, and difficulty finding a position, especially during sleep. Sleep disruptions due to nighttime restlessness or frequent position changes may also occur. Furthermore, most studies on joint hypermobility in the literature primarily involve adults. Early developmental assessments are crucial for preventing developmental delays that may emerge later in life.

Conditions

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Joint Hypermobility Syndrome Sleep Infant

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Joint hypermobility

Joint hypermobility is defined as an increased range of motion in one or more joints compared to the normal range. The Beighton Scoring system is commonly used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Score system includes the following assessments: passive dorsiflexion of the fifth metacarpophalangeal joint, passive hyperextension of the elbow, passive hyperextension of the knee, passive apposition of the thumb to the flexor aspect of the forearm, and forward flexion of the trunk. Infants aged 6-9 months with a Beighton Score \> 4 will be included in the joint hypermobility group.

Beighton Scoring system

Intervention Type BEHAVIORAL

The Beighton Scoring system is commonly used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring system includes the following assessments: passive dorsiflexion of the fifth metacarpophalangeal joint, passive hyperextension of the elbow, passive hyperextension of the knee, passive apposition of the thumb to the flexor aspect of the forearm, and forward flexion of the trunk. A Developmental Physiotherapy and Pediatric Rehabilitation specialist will evaluate the joint hypermobility assessment of infants.

Brief Infant Sleep Questionnaire

Intervention Type BEHAVIORAL

Infant sleep problems are among the most common problems presented to pediatricians. The extended version of the "Brief Infant Sleep Questionnaire" is a questionnaire developed by Sadeh to assess sleep problems and their causes in early childhood.

Healthy infants

A control group consisting of healthy infants, born at term and 6-9-month-old infants without joint hypermobility

Beighton Scoring system

Intervention Type BEHAVIORAL

The Beighton Scoring system is commonly used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring system includes the following assessments: passive dorsiflexion of the fifth metacarpophalangeal joint, passive hyperextension of the elbow, passive hyperextension of the knee, passive apposition of the thumb to the flexor aspect of the forearm, and forward flexion of the trunk. A Developmental Physiotherapy and Pediatric Rehabilitation specialist will evaluate the joint hypermobility assessment of infants.

Brief Infant Sleep Questionnaire

Intervention Type BEHAVIORAL

Infant sleep problems are among the most common problems presented to pediatricians. The extended version of the "Brief Infant Sleep Questionnaire" is a questionnaire developed by Sadeh to assess sleep problems and their causes in early childhood.

Interventions

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Beighton Scoring system

The Beighton Scoring system is commonly used to distinguish individuals with generalized joint hypermobility from those without. The Beighton Scoring system includes the following assessments: passive dorsiflexion of the fifth metacarpophalangeal joint, passive hyperextension of the elbow, passive hyperextension of the knee, passive apposition of the thumb to the flexor aspect of the forearm, and forward flexion of the trunk. A Developmental Physiotherapy and Pediatric Rehabilitation specialist will evaluate the joint hypermobility assessment of infants.

Intervention Type BEHAVIORAL

Brief Infant Sleep Questionnaire

Infant sleep problems are among the most common problems presented to pediatricians. The extended version of the "Brief Infant Sleep Questionnaire" is a questionnaire developed by Sadeh to assess sleep problems and their causes in early childhood.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Term infants
* Infants with joint hypermobility
* Post-term infants between 6 and 9 months old

Exclusion Criteria

* Premature infants
* Infants with congenital malformations
* Infants diagnosed with metabolic, neurological, or genetic diseases
* Infants with joint hypermobility due to any musculoskeletal disease
* Children whose parents did not volunteer for the study
Minimum Eligible Age

6 Months

Maximum Eligible Age

9 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Nigde Omer Halisdemir University

OTHER

Sponsor Role lead

Responsible Party

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Rabia ZORLULAR

principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rabia ZORLULAR

Role: PRINCIPAL_INVESTIGATOR

Nigde Omer Halisdemir University

Locations

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Nigde Omer Halisdemir University

Niğde, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Rabia ZORLULAR

Role: CONTACT

+5424362082

Facility Contacts

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Rabia ZORLULAR

Role: primary

+5424362082

References

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Sedky K, Gaisl T, Bennett DS. Prevalence of Obstructive Sleep Apnea in Joint Hypermobility Syndrome: A Systematic Review and Meta-Analysis. J Clin Sleep Med. 2019 Feb 15;15(2):293-299. doi: 10.5664/jcsm.7636.

Reference Type BACKGROUND
PMID: 30736885 (View on PubMed)

Boran, P., et al., Translation into Turkish of the expanded version of the "Brief Infant Sleep Questionnaire" and its application to infants. Marmara Medical Journal, 2014. 27(3): p. 178-183.

Reference Type BACKGROUND

Sadeh A. A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics. 2004 Jun;113(6):e570-7. doi: 10.1542/peds.113.6.e570.

Reference Type BACKGROUND
PMID: 15173539 (View on PubMed)

Yildiz A, Yildiz R, Burak M, Zorlular R, Akkaya KU, Elbasan B. An investigation of sensory processing skills in toddlers with joint hypermobility. Early Hum Dev. 2024 May;192:105997. doi: 10.1016/j.earlhumdev.2024.105997. Epub 2024 Apr 2.

Reference Type BACKGROUND
PMID: 38614033 (View on PubMed)

Other Identifiers

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joint hypermobility

Identifier Type: -

Identifier Source: org_study_id

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