Gait strategy in patients with Ehlers–Danlos syndrome hypermobility type: A kinematic and kinetic evaluation using 3D gait analysis

The aim of this study was to quantify the gait patterns of adults with joint hypermobility syndrome/Ehlers–Danlos syndrome (JHS/EDS-HT) hypermobility type, using Gait Analysis. We quantified the gait strategy in 12 JHS/EDS-HT adults individuals (age: 43.08 + 6.78 years) compared to 20 healthy controls (age: 37.23 ± 8.91 years), in terms of kinematics and kinetics. JHS/EDS-HT individuals were characterized by a non-physiological gait pattern. In particular, spatio-temporal parameters evidenced lower anterior step length and higher stance phase duration in JHS/EDS-HT than controls. In term of kinematics, in JHS/EDS-HT patients the main gait limitations involved pelvis, distal joints and ankle joint. Conversely, hip and knee joint showed physiological values. Ankle moment and power revealed reduced peak values during terminal stance. Differences in stiffness at hip and ankle joints were found between JHS/EDS-HT and controls. JHS/EDS-HT patients showed significant decreased of Kh and Ka parameters very probably due to congenital hypotonia and ligament laxity. These findings help to elucidate the complex biomechanical changes in JHS/EDS-HT and may have a major role in the multidimensional evaluation and tailored management of these patients.

► Patients with Ehlers–Danlos syndrome are characterized by a non-physiological gait pattern.
► Ehlers–Danlos patients showed significant decreased of hip and ankle stiffens very probably due to congenital hypotonia and ligament laxity.
► Improving pelvis and ankle strategy should represent a specific major goal to optimize gait pattern and prevent the onset of compensatory strategies in Ehlers–Danlos patients.