BACKGROUND: Marfan syndrome (MFS) is an inherited connective disorder that is associated with muscle weakness and ligamentous laxity. Despite documented ligamentous laxity and muscle weakness, the implications of altered musculoskeletal function on the high rate (46%) of self-reported hip pain in the MFS population is not well understood. Assessment of the hip joint loading patterns that occur in individuals with MFS may provide an understanding of this population’s high risk of developing hip pain. Therefore, the purpose of this study was to assess hip joint loading during walking that may help to explain the presence of hip pain in individuals with MFS. METHODS: Thirteen individuals with MFS and thirteen asymptomatic controls were used in this cross-sectional study. Participants underwent 3D gait analysis while walking at the average level ground walking speed (1.35 m/s) for males and females. Using a custom written MATLAB script, the total joint moment (TJM) of the hip joint, was calculated as the square root of the sum of the square of the internal sagittal, frontal, and transverse plane moments, at each frame of the stance phase (initial contact to toe-off). The corresponding sagittal, frontal, and transverse plane moments at the peak TJM in the first and second half of the stance phase were extracted and their percent contribution to the peak TJMs was calculated. Between-group differences in peak TJMs, moments at the TJMs and the corresponding percent moment contributions to the hip TJMs were assessed using an analysis of covariance, adjusting for age, with p<0.05 used for statistical significance. RESULTS: Compared to the control group, the MFS group exhibited a 1.2x larger first peak TJM (p=0.031) and a 1.5x larger first peak abduction moment (p=0.024). Although no differences were observed in the second peak TJM, the MFS group exhibited a 1.2x larger abduction moment (p=0.021) compared to the control group. CONCLUSIONS: Higher abduction moment at the first and second peak TJM in the MFS group may contribute to altered total hip joint loading and may be associated with the high rate of hip pain in MFS. Future work will include a larger sample size as additional TJM-related parameters were underpowered to detect a statistical difference.Research Support: The Marfan Foundation, NIH (KL2-TR001996, K01-AG073698, & K01-HL149984)

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