Gait pattern in 9-11-year-old children with generalized joint hypermobility compared with controls; a cross-sectional study

Abstract

BackgroundTo study differences in gait patterns in 10-year-old children with Generalized Joint Hypermobility (GJH) and with no GJH (NGJH).MethodsA total of 37 children participated (19 GJH, 18 NGJH, mean age 10.2 (SD 0.5) years). Inclusion criteria for GJH were a Beighton score of ≥5, with at least one hypermobile knee joint; for NGJH a Beighton score of ≤4, and no hypermobile knees and for both groups no knee pain during the previous week. All children were recorded by five video cameras, while they walked across three force platforms. Net joint moments were calculated in 3D by inverse dynamics and peak values provided input to statistical analyses.ResultsIn the frontal plane, children with GJH had a significantly lower peak knee abductor moment and peak hip abductor moment. In the sagittal plane, the peak knee flexor moment and the peak hip extensor moment were significantly lower in the GJH group although the absolute difference was small.ConclusionsThe walking pattern was the same for children with GJH and for healthy children, as there were no differences in kinematics, but it was, however, performed with different kinetics. Children with GJH walked with lower ankle, knee and hip joint moments compared to children with NGJH. However, the clinical importance of these differences during normal gait is unknown. To obtain this knowledge, children with GJH must be followed longitudinally.Trial registrationThe study was approved by the Committee on Biomedical Research Ethics for Copenhagen and Frederiksberg, Denmark (jnr. KF01-2006-178).

The three-dimensional kinematics and spatiotemporal parameters of gait in 6–10 year old typically developed children in the Cape Metropole of South Africa – a pilot study

“…Shih et al [36] reported comparable mean peak knee add/abd and knee external/internal rotation values of−2.21 ± 4.42 – 3.42 ± 4.89 and−10.18 ± 6.54 – 3.08 ± 5.07 respectively. The studies by Nikolajsen et al [44] and Kung et al [45] reported only on the joint kinematics during the stance phase of children aged 10 years old and reported similar hip, knee and ankle mean peak values as see in our study for the stance phase. For example, Kung et al [45] reported mean peak knee F, ankle DF and PF of 41.74 ± 3.72; 10.18 ± 3.15 and−11.78 ± 5.14 respectively.…”

“…Although speed affects cadence, step length, stride length and other spatiotemporal parameters, as well as kinematics during gait, our study did not show a significant difference in walking speed between younger and older children [11, 15, 16, 43]. The median speed for the group in the current study compares well with international research based on Mexican children (6–13 years), Australian children (5–13 years) and American children (9–11 years) who walked at a self-selected speed of 1.13(±0.19) ms -1 , 1.37(±0.17) ms -1 and 1.22 (±0.04) ms -1 respectively [35, 37, 44]. Thus, 6–10-year-old South African children’s spatiotemporal parameters of gait fall within the international norms when compared with those of other countries.…”

Prevalence of generalized joint hypermobility, musculoskeletal injuries, and chronic musculoskeletal pain among American university students

“…There is a plethora of studies reporting that patients with BJHS suffer from chronic MSP that may affect their daily lives (Kumar & Lenert, 2017; Morris et al, 2017; Leone et al, 2009; Hakim, Malfait & Paepe, 2010; Grahame & Jenkins, 1972; Scheper et al, 2013; Chustecka, 2004; Grahame, 2000b; Simonsen et al, 2012; Nikolajsen et al, 2013; Voermans et al, 2010; Engelbert et al, 2003; Hanewinkel-Van Kleef et al, 2009). On the other hand, studies looking at a correlation of GJH and MSP have shown inconclusive results only.…”

“…The main complaint of individuals with symptomatic GJH is chronic musculoskeletal pain (MSP) that may affect their daily activities, leading to a decreased quality of life (Kumar & Lenert, 2017; Morris et al, 2017; Leone et al, 2009; Hakim, Malfait & Paepe, 2010; Scheper et al, 2013; Chustecka, 2004; Grahame, 2000b; Simonsen et al, 2012; Nikolajsen et al, 2013). Some individuals complain of pain in several joints (Grahame & Jenkins, 1972), fatigue (Voermans et al, 2010), muscle weakness (Scheper et al, 2014; Engelbert et al, 2003), or diminished motor performance (Hanewinkel-Van Kleef et al, 2009).…”

Chronic pain in hypermobility syndrome and Ehlers–Danlos syndrome (hypermobility type): it is a challenge

“… 33 However, different stabilization strategies (kinetic patterns) have also been shown. 31 , 32 , 34 , 35 In children 36 with nonsymptomatic GJH, only deviations in gait kinematics were observed in terms of lowered joint momentum of the lower extremity. Similar findings were also shown in adults.…”