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. 2024 Mar:113:106210.
doi: 10.1016/j.clinbiomech.2024.106210. Epub 2024 Feb 18.

Assessment of gait mechanics and muscle strength in hypermobile Ehlers Danlos Syndrome

Lindsey N Ball  1 , Mariana V Jacobs  2 , Christopher J McLouth  3 , Jody Clasey  2 , Clair Francomano  4 , Mary B Sheppard  5 , Michael A Samaan  2
Affiliations

Assessment of gait mechanics and muscle strength in hypermobile Ehlers Danlos Syndrome

Lindsey N Ball et al. Clin Biomech (Bristol). 2024 Mar.

Abstract

Background: Hypermobile Ehlers Danlos Syndrome, a heritable connective tissue disorder, is associated with muscle dysfunction, joint subluxations and pain. The impact of hypermobile Ehlers Danlos Syndrome on musculoskeletal mechanics is understudied. Therefore, the aim of this study was to assess the effects of hypermobile Ehlers Danlos Syndrome on lower extremity gait mechanics and muscle strength.

Methods: Eleven people with hypermobile Ehlers Danlos Syndrome and 11 asymptomatic controls underwent a 3D gait analysis and isometric hip and knee muscle strength assessment. Joint subluxations were self-reported by the hypermobile Ehlers Danlos syndrome group. Independent t-tests and Mann Whitney U tests were used to analyze joint mechanics, muscle strength, and patient report outcomes (p < 0.05).

Findings: Both groups exhibited similar walking speeds as well as similar hip, knee, and ankle joint kinematics. The hypermobile Ehlers Danlos Syndrome group walked with a lower peak hip extensor moment (hypermobile Ehlers Danlos Syndrome: -0.52 ± 0.28 Nmˑkg-1, Control: -0.83 ± 0.26 Nmˑkg-1, p = 0.01) yet similar knee and ankle joint moments. The hypermobile Ehlers Danlos Syndrome group exhibited a 40% deficit in peak hip extensor strength (hypermobile Ehlers Danlos Syndrome:1.07 ± 0.53 Nmˑkg-1, Control: 1.77 ± 0.79 Nmˑkg-1, p = 0.04). Approximately 73%, 55% and 45% of the hypermobile Ehlers Danlos Syndrome cohort self-reported hip, knee/patella and ankle joint subluxations, respectively, at least once a week.

Interpretation: Patients with hypermobile Ehlers Danlos Syndrome ambulated with altered hip extensor moments and exhibit hip extensor weakness. Future work should investigate the underlying mechanisms of hip extensor weakness and corresponding effects on joint health in people with hypermobile Ehlers Danlos Syndrome.

Keywords: Ehlers Danlos Syndrome; Gait; Hypermobility; Lower extremity; Strength.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Figure 1:
Figure 1:
Joint Kinematics for the hypermobile Ehlers Danlos group (hEDS; dashed) and healthy control group (solid) during the stance phase.
Figure 2:
Figure 2:
Joint Kinetics for the hypermobile Ehlers Danlos group (hEDS; dashed) and healthy control group (solid) during the stance phase.
See this image and copyright information in PMC

References

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Publication types

Supplementary concepts