Comparing Sagittal Plane Kinematics and Kinetics of Gait and Stair Climbing Between Hypermobile and Non-hypermobile People; a Cross-sectional Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2021 Aug 20

PMID 34412618

Citations 4

Authors

Alexander Vernon Bates

Alison H McGregor

Caroline M Alexander

Affiliations

Soon will be listed here.

Abstract

Background: Joint Hypermobility Syndrome (JHS) presents with a range of symptoms including widespread joint hypermobility and chronic arthralgia. The study objective was to investigate whether impairments in JHS are due to hypermobility or another factor of JHS by identifying impairments in gait and stair-climbing tasks; an activity that is demanding and so may better show differences between the cohorts.

Methods: Sixty-eight adults participated; 23 JHS, 23 Generalised Joint Hypermobility (GJH), and 22 Normal Flexibility (NF). Inclusion criteria for JHS participants were a positive classification using the Brighton Criteria, for GJH a Beighton Score ≥ 4, and for NF a Beighton Score < 4 with no hypermobile knees. Participants were recorded with a 10-camera Vicon system whilst they performed gait and stair-climbing. Temporal-spatial, and sagittal plane kinematic and kinetic outcome measures were calculated and input to statistical analyses by statistical parametric mapping (SPM).

Results: During the gait activity JHS had significantly greater stride time and significantly lower velocity than NF, and significantly greater stride time, lower velocity, and lower stride length than GJH. SPM analysis showed no significant differences between groups in gait kinematics. There were significant differences between groups for gait moments and powers; people with JHS tended to have lower moments and generate less power at the ankle, and favour power generation at the knee. A similar strategy was present in stair ascent. During stair descent people with JHS showed significantly more hip flexion than people with NF.

Conclusions: As there was only one significant difference between GJH and NF we conclude that impairments cannot be attributed to hypermobility alone, but rather other factor(s) of JHS. The results show that both gait and stair-climbing is impaired in JHS. Stair-climbing results indicate that JHS are using a knee-strategy and avoiding use of the ankle, which may be a factor for clinicians to consider during treatment.

Citing Articles

Study on the balance and gait characteristics of subjects with generalized joint hypermobility residing in high-altitude using wearable devices: a cross-sectional study.

Liu M, Guo L, Lin J, Cai Y, Huang X, Wu Y BMC Musculoskelet Disord. 2024; 25(1):837.

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The strength of balance: Strength and dynamic balance in children with and without hypermobility.

Ituen O, Duysens J, Ferguson G, Smits-Engelsman B PLoS One. 2024; 19(6):e0302218.

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Test-retest reliability of kinematic and kinetic parameters during dual-task stair walking in the elderly.

Li Y, Yu N, Zhang C, Song Q, Wang J, Sun W Front Physiol. 2023; 14:1177159.

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An investigation of the control of quadriceps in people who are hypermobile; a case control design. Do the results impact our choice of exercise for people with symptomatic hypermobility?.

Long M, Kiru L, Kassam J, Strutton P, Alexander C BMC Musculoskelet Disord. 2022; 23(1):607.

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