Are Developmental Coordination Disorder (DCD)/Dyspraxia and/or Joint Hypermobility Syndrome inherent determinants of physical inactivity

Abstract

Background: The annual health burden of physical inac-tivity in the UK is estimated to be £1.06 billion. The World Health Organisation recommendations are for adults to be engaged in moderate intensity physical activity for at least half an hour a day on five days a week. It is possible that there are inherent conditions which influence physical activ-ity participation. Children with Developmental Coordination Disorder (DCD)/Dyspraxia are noted to be less physically active than their peers. DCD/Dyspraxia is a neurodevelop-mental disorder affecting motor function and organisation; continues into adulthood and associated with Joint Hyper-mobility Syndrome (JHS). JHS is a multisystemic disorder characterised by chronic pain, musculoskeletal and auto-nomic symptoms and fatigue. Purpose: To explore factors which may affect time spent engaged in weekly physical activity in adults with JHS com-pared with healthy volunteers (HVs). Methods: 90 patients with JHS (mean age 34.7 ± 9.9 years, 83 female), diagnosed by a consultant Rheumatologist according to the Brighton Criteria were compared with 113 HVs with no musculoskeletal pain (mean age 35.7 ± 12.9, 82 female). Information relating to types of physical activity, time spent engaged in physical activity, and common symp-toms associated with JHS (Pain, chronic fatigue, autonomic symptoms, DCD/Dyspraxia) were collected using self-report questionnaires (Functional Difficulties Questionnaire, Phys-ical Activity Questionnaire) and pain chart. Numerical data were analysed using chi square and logistic regression anal-ysis. Results: Walking was the commonest type of physical activity reported (62% HV and 63% Patients with JHS). There was no significant difference in the time spent engaged in physical activity for more than 3 hours a week between Patients with JHS (57%) and HV (66%) chi square 1.75 [95% CI 1.04–4.15] p = 0.187. The odds of patients with JHS with-out DCD/Dyspraxia (70%) being engaged in physical activity for more than 3 hours compared with patients with JHS and DCD/Dyspraxia (47%) were 2.64 [95%CI 1.1–6.4] greater. Both Patients with JHS and HV without DCD/Dyspraxia were 3 times [95%CI 1.43–5.55] more likely to be engaged in physical activity for 3 hours or more a week than patients with JHS and HV with DCD/Dyspraxia. These results indicated that DCD/Dyspraxia was a statistically significant predic-tor of reduced physical activity in both populations. Logistic regression revealed that age, sex, pain, chronic fatigue and autonomic symptoms were not statistically significantly asso-ciated with reduced physical activity in either the patient with JHS or HV groups. Conclusion(s): This is the first study to report the asso-ciation between DCD/Dyspraxia in adults with reduced time spent engaged in weekly physical activity. There was no sig-nificant association of symptoms that might be expected to impact on physical activity participation for example pain, chronic fatigue and autonomic symptoms. Implications: Physical inactivity is a significant burden globally and is the fourth leading risk factor for mortality as one of the major determinants of non-communicable dis-ease (NCD). This study indicates that DCD/Dyspraxia may be a contributor to physical inactivity. The small numbers in this study preclude any generalizability and larger epidemi-ological studies are required to explore this association more thoroughly.