BACKGROUND: Hypermobile Ehlers Danlos Syndrome (hEDS) is a heritable connective tissue disorder that negatively impacts musculoskeletal function and psychological health yet the specific impact of hEDS on gait mechanics and muscle function is not well understood. Our pilot data demonstrated that people with hEDS ambulate with a 37% lower peak hip extensor moment (HEM) and exhibit a 40% deficit in hip extensor strength compared to healthy controls. Approximately 72% of our hEDS cohort also self-reported hip joint subluxations (i.e., increased hip instability) and may be due to altered hip extensor function and mechanics. This hip extensor dysfunction may lead to an increased risk of hip joint pain and degeneration. Although exercise is prescribed as a conservative treatment for hEDS-related joint pain, these exercise protocols lack scientific justification. Therefore, this study will assess the effects of aerobic exercise on hip mechanics and the corresponding relationship of psychological health and hip extensor muscle function with changes in hip joint mechanics and pain during exercise in hEDS. METHODS: Participants will undergo a 3D gait analysis while walking on an instrumented treadmill at a self-selected speed for 30 minutes and we will assess changes in peak HEM and hip pain (VAS). Hip extensor rate of torque development (RTD) will be assessed using isometric strength testing. All participants will complete surveys to assess psychological health (Tampa Scale, and the MHQoL). We will assess the within- and between-group differences in peak HEM using an analysis of variance (p<0.05) while group differences in psychological health, hip pain and muscle function will be assessed using t-tests and non-parametric tests as needed. The relationship between psychological factors and muscle function with changes in peak HEM and hip pain will be assessed using multi-variate linear regression. A minimum of 20 total participants (f=0.35) will provide a minimum of 84% power to detect statistical differences. ANTICPATED RESULTS: We hypothesize that the hEDS group will exhibit reduced peak HEM and increased hip pain during the walking task, as well as worse psychological health and hip extensor RTD compared to controls. Our study results will identify the specific biomechanical, muscular and psychological targets for a multi-disciplinary exercise intervention to improve hip mechanics and reduce hip pain in hEDS. This research was supported in part by the University of Kentucky Department of Kinesiology and Health Promotion Graduate Student Research Funding and NIH (K01AG073698 & K01-HL149984)

This document is currently not available here.