Gait biomechanics in joint hypermobility syndrome: a spatiotemporal, kinematic and kinetic analysis

Abstract

Introduction Joint hypermobility syndrome (JHS) symptoms of widespread joint hypermobility and pain, muscle weakness and reduced muscle‐tendon stiffness suggest that there may be an impact on gait parameters. Identification of gait abnormalities may inform assessment and management. The objective in the present study was to use a cross‐sectional designed study to explore the impact of JHS on gait parameters. Methods A JHS group of 29 participants (mean age 37.57 (S.D. 13.77) years) was compared to a healthy control group of 30 participants (mean 39.27 (S.D. 12.59) years). Spatiotemporal parameters, joint kinematics and joint kinetics were captured using the Qualisys motion capture system synchronized with a Kistler force platform. Results Statistically significant reductions in walking speed, stride length and step length were found in the JHS group, while stance and double support durations were significantly increased (p < 0.01). During the swing phase, the JHS group showed significantly less knee flexion (p < 0.01). Reductions in hip extensor moment, and knee power generation and absorption were identified in the JHS group (p < 0.01). No other gait parameters were significantly altered. Conclusion The JHS group walked more slowly with a kinematic ‘stiffening’ pattern. Hypermobility was not evident during gait. The observed stiffening pattern could be a strategy to avoid pain and improve balance. Impairments in moment and power generation could be related to several symptomatic and etiological factors in JHS. Clinicians should carefully consider gait in the assessment and management of people with JHS targeting the impairments identified by the current study.

Generalized joint hypermobility among school-aged children in Majmaah region, Saudi Arabia

“…However, in most cases, joint hypermobility is observed as a confined phenomenon referred to as generalized joint hypermobility (GJH). Rarely, in the absence of any genetic disorders, joint hypermobility is associated with features such as arthralgia, back pain, dislocation/subluxation, soft tissue rheumatic disorders, marfanoid habitus, skin abnormalities, eye signs, incompetence of the lower-limb vessel valves, or rectal hernia or prolapse and is termed joint hypermobility syndrome (Alsiri et al, 2020;Armon & Bale, 2012;Clinch et al, 2011;Palmer et al, 2014;Palmer et al, 2015).…”

Altered Multisegment Ankle and Foot Kinematics During Gait in Patients With Hypermobile Ehlers‐Danlos Syndrome/Hypermobility Spectrum Disorder: A Case–Control Study

“…Patients have been shown to walk with a reduced gait velocity, step length, and/or stride length (9,10,12,13,15,16). In addition, hEDS individuals show altered kinematics of the pelvis, hip, knee, and ankle during the different phases of gait (9,12,13,14,16). However, for the latter, current findings are limited to the foot modeled as 1 single rigid segment, oversimplifying the complexity of the ankle‐foot complex or even contradicting true ankle joint kinematics (17).…”

“…Until now, several studies have investigated gait in patients with hEDS/HSD (9,10,(12)(13)(14)(15)(16). Patients have been shown to walk with a reduced gait velocity, step length, and/or stride length (9,10,12,13,15,16).…”

“…Until now, several studies have investigated gait in patients with hEDS/HSD (9,10,(12)(13)(14)(15)(16). Patients have been shown to walk with a reduced gait velocity, step length, and/or stride length (9,10,12,13,15,16). In addition, hEDS individuals show altered kinematics of the pelvis, hip, knee, and ankle during the different phases of gait (9,12,13,14,16).…”

Peer Review #1 of "Generalized joint hypermobility among school-aged children in Majmaah region, Saudi Arabia (v0.1)"

“…However, in most cases, joint hypermobility is observed as a confined phenomenon referred to as generalized joint hypermobility (GJH). Rarely, in the absence of any genetic disorders, joint hypermobility is associated with features such as arthralgia, back pain, dislocation/subluxation, soft tissue rheumatic disorders, marfanoid habitus, skin abnormalities, eye signs, incompetence of the lower-limb vessel valves, or rectal hernia or prolapse and is termed joint hypermobility syndrome (Alsiri et al, 2020;Armon et al, 2012;Clinch et al, 2011;Palmer et al, 2014;Palmer et al, 2015).…”