Gait strategy in patients with Ehlers-Danlos syndrome hypermobility type and Down syndrome.
Down syndrome gait shows floppy ankles plus stiff hips, a pattern that differs from Ehlers-Danlos and points to targeted ankle support.
01Research in Context
What this study did
Chiara et al. filmed 24 people walking on a lab treadmill. Eight had Down syndrome, eight had Ehlers-Danlos hypermobility, and eight were typical adults.
Reflective markers tracked ankle, knee, and hip motion. Software turned the video into joint-stiffness numbers for each group.
What they found
Down syndrome walkers showed the roughest gait. They had floppy ankles, just like the Ehlers-Danlos group.
But at the hip, the two groups split. Down syndrome folks stiffened their hips to stay stable, while Ehlers-Danlos folks let the hips stay loose.
How this fits with other research
Rieth et al. (2022) also found poor leg muscle quality in teens with Down syndrome. Their quick grip-to-BMI test lines up with Chiara’s lab data: weak ankles are a red flag.
Wee et al. (2015) showed Down syndrome adults hit lower peak heart rates. Chiara’s stiff-hip strategy may explain why walking costs them extra energy.
Micai et al. (2021) meta-analysis found small inhibition deficits in Down syndrome. Chiara’s study adds that motor, not just mental, control issues are part of the profile.
Why it matters
When you see a client with Down syndrome walk, expect floppy ankles and stiff hips. Use ankle braces or taped supports to cut fatigue. Pick exercises that build ankle strength without forcing extra hip work, and you’ll boost safe community walking.
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02At a glance
03Original abstract
People suffering from Ehlers-Danlos syndrome (EDS) hypermobility type present a severe ligament laxity that results in difficulties in muscle force transmission. The same condition is present in people suffering from Down syndrome (DS) even if their clumsy movements are due to cerebral and cognitive impairments. The aim of this study was to quantify the gait patterns of subjects with EDS and with DS using Gait Analysis (GA). We quantified the gait strategy in 12 EDS individuals and in 16 participants with DS. Both pathological groups were compared to 20 age-matched healthy controls in terms of kinematics and kinetics. Results showed that DS individuals are characterized by a more compromised gait pattern than EDS participants, even if both groups are characterized by joint hypermobility. All the patients showed significant decreased of ankle stiffness probably due to congenital hypotonia and ligament laxity, while different values of hip stiffness. These findings help to elucidate the complex biomechanical changes due to joint hypermobility and may have a major role in the multidimensional evaluation and tailored management of these patients.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.03.016