Comparing sagittal plane kinematics and kinetics of gait and stair climbing between hypermobile and non-hypermobile people; a cross-sectional study

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Title: Comparing sagittal plane kinematics and kinetics of gait and stair climbing between hypermobile and non-hypermobile people; a cross-sectional study
Authors: Bates, A
McGregor, A
Alexander, C
Item Type: Journal Article
Abstract: Background: Joint Hypermobility Syndrome (JHS) presents with a range of symptoms including widespread joint hypermobility and chronic arthralgia. The study objective was to investigate whether impairments in JHS are due to hypermobility or another factor of JHS by identifying impairments in gait and stair-climbing tasks; an activity that is demanding and so may better show differences between the cohorts. Methods: 68 adults participated; 23 JHS, 23 Generalised Joint Hypermobility (GJH), and 22 Normal Flexibility (NF). Inclusion criteria for JHS participants were a positive classification using the Brighton Criteria, for GJH a Beighton Score ≥4, and for NF a Beighton Score <4 with no hypermobile knees. Participants were recorded with a 10-camera Vicon system whilst they performed gait and stair-climbing. Temporal-spatial, and sagittal plane kinematic and kinetic outcome measures were calculated and input to statistical analyses by statistical parametric mapping (SPM). Results: During the gait activity JHS had significantly greater stride time and significantly lower velocity than NF, and significantly greater stride time, lower velocity, and lower stride length than GJH. SPM analysis showed no significant differences between groups in gait kinematics. There were significant differences between groups for gait moments and powers; people with JHS tended to have lower moments and generate less power at the ankle, and favour power generation at the knee. A similar strategy was present in stair ascent. During stair descent people with JHS showed significantly more hip flexion than people with NF. Conclusions: As there was only one significant difference between GJH and NF we conclude that impairments cannot be attributed to hypermobility alone, but rather other factor(s) of JHS. The results show that both gait and stair-climbing is impaired in JHS. Stair-climbing results indicate that JHS are using a knee-strategy and avoiding use of the ankle, which may be a factor for clinicians to consider during treatment.
Issue Date: 19-Aug-2021
Date of Acceptance: 12-Jul-2021
DOI: 10.1186/s12891-021-04549-2
ISSN: 1471-2474
Publisher: BioMed Central
Start Page: 1
End Page: 9
Journal / Book Title: BMC Musculoskeletal Disorders
Volume: 22
Issue: 712
Copyright Statement: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Sponsor/Funder: Imperial Health Charity
Keywords: Adult
Biomechanical Phenomena
Cross-Sectional Studies
Stair Climbing
Cross-Sectional Studies
Biomechanical Phenomena
Stair Climbing
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2021-08-19
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons