Title: Characterization of Lower Extremity Joint dynamics in Children with Hypermobile Ehlers-Danlos Syndrome During Gait
Name: Anahita Qashqai
Primary Presenters: Anahita Qashqai
College of Health Sciences
Research Doctorate (PhD)
Faculty Sponsor(s): Brooke Slavens

Hypermobile Ehlers-Danlos syndrome (hEDS) is a heritable connective tissue disorder. hEDS is characterized by joint laxity, excessive joint ranges of motion, pain, and fatigue during walking. Despite this clinical knowledge, there is limited biomechanical characterizations of gait in children with hEDS. Therefore, the purpose of this study was to quantify lower extremity joint kinematics, moments, and powers during walking in children with hEDS in comparison to typically developing (TD) children.
Eight children (4 males, 4 females, age: 14.5 ± 2.8 years) with hEDS participated. A 15-camera Vicon motion capture system and four AMTI force plates recorded trajectories and ground reaction forces. The Vicon Plug-in Gait model was applied to compute joint dynamics. An open-source dataset from 83 healthy children (age: 10.5 ± 3.5 years) were used. Mann-Whitney U tests were applied to assess group differences (p < 0.05).
Of the joint kinematics assessed, only peak hip extension significantly differed between the groups (hEDS: 10.3±5.2 vs. TD: 5.7±3.4 deg, p=0.04). Children with hEDS exhibited a significantly greater peak ankle plantarflexion moment (hEDS: 1.6±0.2 vs. TD: 1.1±0.1 N-m/kg, p=0.02). Furthermore, children with hEDS exhibited significantly greater ankle power generation (hEDS: 30.1±15. vs. TD: 11.6±5.2 J/kg, p<0.01), less knee power absorption (hEDS: 10.3±2.9 vs. TD: 19.5±3.2 J/kg, p<0.01), as well as less hip power generation (hEDS: 19.1±4.6 vs. TD: 11.4±2.1 J/kg) and more hip power absorption (hEDS: 7.9±3.4 vs. TD: 2.3±0.4 J/kg, p<0.01).
While no significant differences occurred in peak ankle and knee angles, the hEDS group demonstrated altered moments and powers. This difference may be related to the fact that similar kinematic patterns can be produced by different kinetics. While we observed significantly greater ankle power generation in those with hEDS, less hip power generation were found. This may be the indication that the propulsion may be generated mainly by the ankle.

https://sites.uwm.edu/healthresearchsymposium/files/formidable/2/References.pdf