Department of Health and Applied Sciences, University of the West of England, Bristol, UK.
Al-razi Orthopedic and Rehabilitation Hospital, Kuwait City, Kuwait.
Musculoskeletal Care. 2020 Sep;18(3):301-314. doi: 10.1002/msc.1461. Epub 2020 Feb 22.
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.
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.
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.
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.
关节过度活动综合征(JHS)的症状包括广泛的关节过度活动和疼痛、肌肉无力以及肌肉-肌腱僵硬度降低,这表明可能会对步态参数产生影响。识别步态异常可能有助于评估和管理。本研究的目的是使用横断面设计研究来探讨 JHS 对步态参数的影响。
将 29 名 JHS 参与者(平均年龄 37.57(S.D. 13.77)岁)与 30 名健康对照组参与者(平均年龄 39.27(S.D. 12.59)岁)进行比较。使用 Qualisys 运动捕捉系统结合 Kistler 力台来获取时空参数、关节运动学和关节动力学。
JHS 组的行走速度、步长和步长明显降低,而支撑和双支撑时间明显延长(p<0.01)。在摆动阶段,JHS 组的膝关节屈曲明显减少(p<0.01)。JHS 组的髋关节伸肌力矩、膝关节功率生成和吸收减少(p<0.01)。其他步态参数没有明显改变。
JHS 组行走速度较慢,呈现运动学“僵硬”模式。在步态中没有明显的过度活动。观察到的僵硬模式可能是一种避免疼痛和改善平衡的策略。力矩和功率生成的损伤可能与 JHS 的几个症状和病因因素有关。临床医生在评估和管理 JHS 患者时应仔细考虑步态,针对本研究中发现的损伤进行靶向治疗。