Hospital del Mar Criteria

What is hypermobility?

Hypermobility refers to the ability of joints to move beyond the normal range of motion. This condition can vary from person to person, with some individuals experiencing mild hypermobility and others facing more severe symptoms. The cause of hypermobility is often linked to the structure of connective tissue, which genetic factors can influence.

Symptoms of hypermobility can include joint pain, frequent sprains, and an increased risk of dislocations. While some people may not experience any discomfort, others may develop joint hypermobility syndrome or conditions like Ehlers-Danlos syndrome, which require medical attention and management. It's essential to distinguish between benign joint hypermobility and these more severe conditions to ensure appropriate care.

How to assess hypermobility?

To assess hypermobility, healthcare professionals employ standardized methods and criteria that evaluate joint mobility. One widely recognized tool is the Beighton Score, which comprehensively assesses joint hypermobility across multiple joints. This criteria is particularly useful in pediatric populations, clinical rheumatology settings, and schools.

Studies in the Journal of Rheumatology and Rheumatic Diseases highlight the prevalence of hypermobility and provide essential data on its occurrence in various populations (Öhman et al., 2014). Results from these assessments are crucial for understanding and managing hypermobility effectively.

What is the Hospital del Mar Criteria?

The Hospital del Mar Criteria is a standardized method for evaluating joint hypermobility by assessing the range of motion in specific joints. It includes assessments of the little finger, thumb, elbow, shoulder rotation, hip, knee extension and flexion, patella, ankle, metatarsophalangeal joint, and trunk mobility.

How does our Hospital del Mar Criteria template work?

Our Hospital del Mar Criteria template simplifies the assessment process by providing a structured format for evaluating joint hypermobility. Here's how it works after you download it from our resources tab:

• Assess joints: The template includes sections for assessing hypermobility in the little finger, thumb, elbow, shoulder rotation, hip, knee extension and flexion, patella, ankle, metatarsophalangeal joint, and trunk mobility.
• Scoring system: Hypermobility is assessed in passive movement for each joint bilaterally. Only one point is given regardless of whether the hypermobility is bilateral or unilateral. The maximum total score is 10 points.
• Interpretation: A higher total score indicates greater overall joint laxity. Specific cut-off scores for hypermobility diagnosis vary, and adjustments may be needed based on age and ethnicity.

Scoring the Hospital del Mar Criteria

The scoring system of the Hospital del Mar Criteria is straightforward:

• 1 point is awarded for each joint exhibiting hypermobility, regardless of laterality.
• The maximum score is 10 points, whereas higher scores indicate higher hypermobility.
• Adjustments may be necessary based on the patient's age and ethnicity to ensure accurate assessment.

Benefits of using our template

Using our Hospital del Mar Criteria template offers several benefits:

Standardization

The template provides a standardized method for assessing joint hypermobility across multiple joints, ensuring reliable and comparable results.

Ease of use

The clear and concise format simplifies the assessment process for healthcare professionals, allowing for efficient evaluations during busy clinical settings or research studies.

Reliability

Studies have shown high inter-rater reliability when using the Hospital del Mar Criteria (Öhman et al., 2014). This ensures that results are consistent regardless of the assessor.

Comprehensive assessment

The template covers many joints, including the little finger, thumb, elbow, shoulder, hip, knee, patella, ankle, and metatarsophalangeal joint. This comprehensive approach provides a holistic view of the patient's joint mobility, enabling a more accurate diagnosis and targeted treatment plan.

Adaptability

The criteria can be adjusted for different age groups and ethnicities, ensuring the assessment remains accurate and relevant for the evaluated population. This flexibility allows healthcare professionals to tailor the template to their needs and patient demographics.

Validated tool

The Hospital del Mar Criteria have been extensively studied and validated in various settings, with results published in reputable journals like the Journal of Rheumatology. This evidence-based approach ensures the template is a reliable and effective tool for assessing joint hypermobility.

By incorporating these benefits, our printable Hospital del Mar Criteria template offers a robust solution for healthcare professionals and researchers working in joint hypermobility assessment.

Management and treatment of hypermobility

Management and treatment of hypermobility often involve a combination of approaches:

• Physical therapy: Strengthening exercises to improve joint stability and reduce pain. Proprioceptive training to enhance joint position sense and prevent injuries. Stretching and range-of-motion exercises to maintain flexibility. Bracing or taping for joint support during activities.
• Pain management: Medications like acetaminophen, NSAIDs, or topical creams for pain relief. Heat/cold therapy to manage acute pain and inflammation. Transcutaneous electrical nerve stimulation (TENS) for pain modulation.
• Education and lifestyle modifications: Teaching patients joint protection techniques, such as avoiding hyperextension, modifying activities to reduce joint stress and prevent injuries, and Maintaining a healthy weight to minimize joint loading.
• Monitoring and reassessment: Regular evaluations using tools like the Hospital del Mar Criteria to track changes in joint mobility. Adjusting treatment plans based on individual progress and needs. Monitoring for the development of hypermobility-related conditions like Ehlers-Danlos syndrome.
• Multidisciplinary approach: Involving a team of healthcare providers, including rheumatologists, physical therapists, and pain management specialists. Coordinating care to address the various aspects of hypermobility management.
• Considerations for special populations: Tailoring treatment plans for children, considering their growth and development. Addressing gender-specific issues, such as hormonal changes in women. Adapting interventions for older adults to maintain function and prevent falls.

The Hospital del Mar criteria can be valuable in assessing joint mobility and guiding treatment decisions.

Reference

Öhman, A., Westblom, C., & Henriksson, M. (2014). Paediatric rheumatology Hypermobility among school children aged five to eight years: the Hospital del Mar criteria gives higher prevalence for hypermobility than the Beighton score. Clinical and Experimental Rheumatology, 32, 285–290.