Relationship between fatigue and gait abnormality in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type.
In hypermobile adults, higher fatigue equals lighter steps—cheap force data can flag energy drops before clients complain.
01Research in Context
What this study did
Celletti et al. (2012) watched 11 adults walk across a lab force plate. All had joint hypermobility syndrome or Ehlers-Danlos hypermobility type.
Each person filled out a quick fatigue scale, then walked normally while the plate measured the downward push of every step.
What they found
The more tired people said they felt, the lighter their steps hit the ground. The link was strong enough to show up in a small group.
In short, self-reported fatigue showed up as a real, measurable drop in vertical force.
How this fits with other research
Matson et al. (2013) also used 3-D gait labs, but in kids with cerebral palsy. They found extra random noise in each step instead of lower force. Same tool, different signal.
Spolaor et al. (2025) looked at Fragile-X kids and saw heavy use of fast-twitch fibers while walking. That motor-unit choice drains energy fast, so the authors warn these kids tire quickly. Claudia’s adults already feel that fatigue and it shows up as softer footfalls.
Mount et al. (2011) push us to use better stats when we study motor variability. Claudia’s team used standard force curves, but R’s random-coefficient method could catch individual fatigue patterns we might miss.
Why it matters
If you work with hypermobile clients, a simple force-plate walk can give you an objective fatigue read-out. No need to rely only on "I feel tired." Drop the vertical force number into your data sheet and use it to pace therapy, schedule rest breaks, or justify reduced session intensity to funders.
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02At a glance
03Original abstract
Ehlers-Danlos syndrome (EDS) is a clinically and genetically heterogeneous group of inherited connective tissue disorders characterised by joint hypermobility, skin hyperextensibility and tissue fragility. It has recently been shown that muscle weakness occurs frequently in EDS, and that fatigue is a common and clinically important symptom. The aim of this study was to investigate the relationship between fatigue severity and the gait pattern using 3D Gait Analysis (GA). Eleven individuals with Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility type (JHS/EDS-HT) were investigated using muscle strength measured with standardised questionnaire measuring fatigue (Fatigue Severity Scale, FSS) and quantitative 3D GA. Our data showed that FSS value well correlated with the peak of vertical component of ground reaction force (r=-0.66, p<0.05). The negative correlation gives evidence that the higher the fatigue is the more reduced force is during gait. Our results showed that the ground reaction force has been applied as a functional evaluation score for detecting pathology in gait of JHS/EDS-HT participants and the found correlation between vertical force and fatigue demonstrated that muscle fatigue may be associated with a loss of proprioceptive acuity in lower limb muscles.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.06.018