Reproducibility of Hypermobility Assessment Scales for Children When Performed Using Telehealth versus In-Person Modes

Evaluate reproducibility of hypermobility assessments using in-person versus telehealth modes. Hypermobility of 20 children (7–12 years) was evaluated using the Beighton Score, Upper Limb Hypermobility Assessment Tool (ULHAT), and Lower Limb Assessment Score (LLAS) via in-person and telehealth modes. Agreement between the two modes was examined using percentage of exact agreement (� and � ± 2), Limits of Agreement (LoA) and Smallest detectable change (SDC). Reliability was calculated using intra-class correlation coefficients (ICCs). Agreement between modes for total Scores was best for the Beighton (� = fair, � ± 2 = good), then the ULHAT (� = poor, � ± 2 = excellent), and LLAS (� = poor, � ± 2 = fair). Total scores for all scales showed wide LoA, large SDC (25-31%), and fair to good reliability (ICC = 0.54–0.61). Exact agreement for Generalized Joint Hypermobility classification was excellent for the Beighton (≥7/9 threshold) and fair for the ULHAT and LLAS (≥7/12 threshold). Percentage of individual test items with good/excellent agreement was highest for the Beighton (78%, 7/9 items), then the ULHAT (58%, 14/24) and LLAS (42%, 10/24). Total Scores of hypermobility scales showed low exact agreement between in-person and telehealth, but fair–excellent agreement within two points. Classification using the Beighton ≥7/9 threshold was excellent. Research is recommended to increase accuracy of online assessments.