Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Elizabeth Gaskell Campus, Hathersage Road, Manchester M13 0JA, UK.
Gait Posture. 2011 Mar;33(3):447-51. doi: 10.1016/j.gaitpost.2010.12.022.
Hypermobility syndrome (HMS) is characterised by generalised joint laxity and musculoskeletal complaints. Gait abnormalities have been reported in children with HMS but have not been empirically investigated. The extent of passive knee joint range of motion (ROM) has also not been well reported in children with HMS. This study evaluated gait kinematics and passive knee joint ROM in children diagnosed with HMS and healthy controls. Thirty-seven healthy children (mean age±SD=11.5±2.6 years) and 29 children with HMS (mean age±SD=11.9±1.8 years) participated. Sagittal knee motion and gait speed were evaluated using a VICON 3D motion analysis system. Passive knee ROM was measured with a manual goniometer. Independent t-tests compared the values of sagittal knee motion and gait speed between the two groups. Mann-Whitney U tests compared passive knee ROM between groups. Passive ROM (extension and flexion) was significantly higher (both p<0.001) in children with HMS than the healthy controls. Peak knee flexion (during loading response and swing phase) during walking was significantly lower (both p<0.001) in children with HMS. Knee extension in mid stance during walking was significantly increased (p<0.001) in children with HMS. However, gait speed was not statistically (p=0.496) different between the two groups. Children with HMS had higher passive knee ROM than healthy children and also demonstrated abnormal knee motion during gait. Gait re-education and joint stability exercise programmes may be of value to children with HMS.
过度活动综合征（HMS）的特征是全身性关节松弛和肌肉骨骼投诉。已有报道称 HMS 患儿存在步态异常，但尚未进行实证研究。HMS 患儿的膝关节被动活动范围（ROM）也没有得到很好的报道。本研究评估了诊断为 HMS 的儿童和健康对照组的步态运动学和膝关节被动 ROM。37 名健康儿童（平均年龄±SD=11.5±2.6 岁）和 29 名 HMS 患儿（平均年龄±SD=11.9±1.8 岁）参与了研究。使用 VICON 3D 运动分析系统评估矢状面膝关节运动和步态速度。使用手动量角器测量膝关节被动 ROM。独立 t 检验比较两组的矢状面膝关节运动和步态速度值。Mann-Whitney U 检验比较两组之间的膝关节被动 ROM。HMS 患儿的膝关节被动 ROM（伸展和屈曲）明显高于健康对照组（均 p<0.001）。行走时膝关节屈曲峰值（在负荷反应和摆动阶段）明显低于 HMS 患儿（均 p<0.001）。行走时膝关节伸展在中间站立时明显增加（p<0.001）。然而，两组之间的步态速度没有统计学差异（p=0.496）。HMS 患儿的膝关节被动 ROM 高于健康儿童，且在行走时膝关节运动也存在异常。步态再教育和关节稳定性运动方案可能对 HMS 患儿有价值。
