Dynamic balance during gait in children and adults with Generalized Joint Hypermobility

Background: The purpose of the study was to investigate if differences of the head and trunk stability and stabilization strategies exist between subjects classified with Generalized Joint Hypermobility and healthy controls during gait It was hypothesized that joint hypermobility could lead to decreased head and trunk stability and a head stabilization strategy similar to what have been observed in individuals with decreased locomotor performance. Methods: A comparative study design was used wherein 19 hypermobile children were compared to 19 control children, and 18 hypermobile adults were compared to 18 control adults. The subjects were tested during normal walking and walking on a line. Kinematics of head, shoulder, spine and pelvis rotations were measured by five digital video cameras in order to assess the segmental stability (angular dispersion) and stabilization strategies (anchoring index) in two rotational components: roll and yaw. Findings: Hypermobile children and adults showed decreased lateral trunk stability in both walking conditions. In hypermobile children, it was accompanied with decreased head stability as the head was stabilized by the inferior segment when walking on a line. Several additional differences were observed in stability and stabilization strategies for both children and adults. Interpretation: Stability of the trunk was decreased in hypermobile children and adults. This may be a consequence of decreased stability of the head. Hypermobile children showed a different mode of head stabilization during more demanding locomotor conditions indicating delayed locomotor development. The findings reflect that Generalized Joint Hypermobility probably include motor control deficits. (C) 2013 Elsevier Ltd. All rights reserved.