Assessment & Research

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

Galli et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

Adults with Ehlers-Danlos hypermobility walk with weak ankle push-off and stiff joints, a pattern now seen across autism and Down syndrome studies.

✓ Read this if BCBAs who treat hypermobile teens or adults in day-program or clinic settings.
✗ Skip if Clinicians looking for behavior-intervention data; this is pure biomechanics.

01Research in Context

01

What this study did

Researchers filmed adults with Ehlers-Danlos hypermobility while they walked.

Special 3-D cameras tracked joint angles and foot pressure.

The team compared each person to adults without the syndrome.

02

What they found

The EDS group pushed off with weaker ankles.

Their joints looked stiffer, not looser, while walking.

The pattern was different from typical gait, but the paper did not say if it was better or worse.

03

How this fits with other research

Hasan et al. (2017) saw weak ankle push-off in kids with autism.

Whitehouse et al. (2014) also found low ankle power in children with Down syndrome who had flat feet.

All three studies used 3-D tools and point to the same ankle weakness, even though the diagnoses differ.

Hopkins et al. (2011) adds that autistic kids walk with a stiffer trunk, showing the problem can spread above the ankle.

04

Why it matters

If you work with hypermobile clients, watch how they finish a step.

Weak ankle power can make walking tiring and balance shaky.

Adding heel-rise drills or orthotics may give the push-off they lack.

Track changes with simple video; you do not need a motion lab.

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Film your client walking, count how many single-leg heel raises they can do, then add ten reps to each session.

02At a glance

Intervention
not applicable
Design
other
Sample size
12
Population
other
Finding
not reported

03Original abstract

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.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.018