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

IntroductionJoint 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.MethodsA 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.ResultsStatistically 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.ConclusionThe 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

Comparação entre indivíduos hemiparéticos com e sem histórico de quedas com base nos componentes da Classificação Internacional de Funcionalidade, Incapacidade e Saúde Comparison between post-stroke hemiparetic subjects with and without history of falls on the basis of the International Classification of Functioning, Disability and Health

O objetivo deste estudo foi comparar hemiparéticos com e sem histórico de quedas nos últimos seis meses (caidores e não-caidores) segundo os componentes da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Dezesseis hemiparéticos não-caidores (62,3±16,6 anos), com tempo de acidente vascular encefálico (AVE) de 38,0±48,3 meses, e 16 caidores (61,0±17,0 anos), tempo de AVE de 48,0±50,7 meses, de ambos os sexos, comunitários e deambuladores, foram avaliados quanto a funções e estruturas do corpo (torque do músculo quadríceps do lado parético e escala de depressão geriátrica), atividade - velocidade de marcha (VM) natural e máxima, teste de levantar e caminhar cronometrado (timed up & go) e escala de equilíbrio de Berg - e participação (pelo perfil de saúde de Nottingham e escala de qualidade de vida específica para AVE). Os dados foram tratados estatisticamente, com nível de significância &#945;<0,05. Não houve diferença significativa entre os grupos quanto à idade, sexo e tempo de AVE (0,56<p<0,82), nem quanto às demais caracteristicas medidas (torque, depressão, VM, equilíbrio e qualidade de vida (0,12<p<0,60). Portanto, hemiparéticos caidores apresentaram-se semelhantes aos não-caidores nos domínios funções e estruturas do corpo, atividades e participação. Fatores contextuais ambientais, não analisados, podem estar mais relacionados a episódio(s) de queda nesses indivíduos.<br>The aim of this study was to compare post-stroke hemiparetic subjects with and without history of falls over the last six months by using the International Classification of Functioning, Disability and Health (ICF) components. Sixteen community-dwelling hemiparetic subjects without history of falls (62.3±16.6 years, time since stroke 38±48.3 months), and 16 with history of fall(s) (60.9±17 years, time since stroke 47.9±50.8 months) of both sexes and able to walk, with or without assistive devices, were assessed as to ICF components body functions and structures (torque of the paretic limb quadriceps muscle and depression, by the geriatric depression scale), activities (natural and maximal gait speed, timed up-and-go test and Berg balance scale), and participation (by the Nottingham health profile and the stroke-specific quality of life scale). Groups were statistically compared at significance level &#945;<0.05. No statistically significant differences were found between the groups as to age, gender or time since stroke (0.56<p<0.82), neither as to all measured features (torque, depression, gait speed, balance, health-related quality of life (0.12<p<0.60). Therefore, stroke subjects with history of falls were similar to those without history of falls in all measures related to the ICF, suggesting that non-analysed environmental factors might be more related to falls of hemiparetic post-stroke subjects