Presentation of Young Adults With and Without Joint Hypermobility

Most hyper mobility-related research is conducted by clinical researchers, who are generally limited to recruiting research subjects from patients who present to their clinics. There are few opportunities for longitudinal studies of asymptomatic or 'healthy' individuals to identify potential triggers prospectively and to compare to people who do not develop symptoms. A health care academic institution provides the ideal environment for a prospective study, somewhat like the 'Nurses Health Study'* that followed a population of nurses throughout their lives.

The study will collect initial data on:

• Current diagnoses related to HSD, MCAS, and POTS (questionnaire)
• Current symptoms associated with HSD, MCAS and POTS (questionnaire)
• Overall quality of life (questionnaire)
• Physical measures for diagnosing joint hypermobility and instability
• Physical screening for POTS
• Physical screening for body awareness, balance and coordination

Objectives and Hypotheses

1. What is the prevalence of HSD, POTS and MCAS in a 'healthy' young adult population?
2. How often are HSD, POTS and MCAS undiagnosed in a 'healthy' young adult population?
3. Are there factors that trigger or precede the development of widespread symptoms in people who have GJH, causing them to develop HSD?
4. What risk factors are associated with increased likelihood that an individual will develop POTS, MCAS, or HSD?
5. Do balance or motor control in the neck differ in asymptomatic joint hypermobility compared to symptomatic hypermobility?
6. If coordination impairments exist in asymptomatic people with hypermobility, does that predict development of HSD?

Questionnaires will be on secure Google Forms accessed through participants' phones or other electronic devices. Participants may pause and return to the questionnaires if they choose. We intend for the questionnaires to require no more than 30 minutes to complete; we may need to eliminate questions from the current list to achieve this.

Physical measurements will be performed only at the initial data collection. These measurements will be performed by licensed physical therapists, who may be assisted by physical therapy graduate students with adequate training to assist in selected data collection. Data collection will take place in Clarkson Hall. Measurements are likely to be performed at 'stations' by various assessors, but any participant who would like to be in a private room for any or all of the assessment may request that. Physical measurements are likely to take about 30 minutes.

Each year, we will follow up by emailing participants asking them to complete questionnaires that will be a subset of the initial set of questions. Questionnaires will again be implemented through secure Google Forms.