Adaptation of balance reactions following forward perturbations in people with joint hypermobility syndrome

Abstract Background Joint Hypermobility Syndrome (JHS) is a Heritable Disorder of Connective tissue characterised by joint laxity and chronic widespread arthralgia. People with JHS exhibit a range of other symptoms including balance problems. To explore balance further, the objective of this study is to compare responses to forward perturbations between three groups; people who are hypermobile with (JHS) and without symptoms and people with normal flexibility. Methods Twenty-one participants with JHS, 23 participants with Generalised Joint Hypermobility (GJH) and 22 participants who have normal flexibility (NF) stood on a platform that performed 6 sequential, sudden forward perturbations (the platform moved to the anterior to the participant). Electromyographic outcomes (EMG) and kinematics for the lower limbs were recorded using a Vicon motion capture system. Within and between group comparisons were made using Kruskal Wallis tests. Results There were no significant differences between groups in muscle onset latency. At the 1st perturbation the group with JHS had significantly longer time-to-peak amplitude than the NF group in tibialis anterior, vastus medialis, rectus femoris, vastus lateralis, and than the GJH group in the gluteus medius. The JHS group showed significantly higher cumulative joint angle (CA) than the NF group in the hip and knee at the 1st and 2nd and 6th perturbation, and in the ankle at the 2nd perturbation. Participants with JHS had significantly higher CA than the GJH group at the in the hip and knee in the 1st and 2nd perturbation. There were no significant differences in TTR. Conclusions The JHS group were able to normalise the timing of their muscular response in relation to control groups. They were less able to normalise joint CA, which may be indicative of impaired balance control and strength, resulting in reduced stability.

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Electromyographic evaluation of the lower limbs of patients with Down syndrome in hippotherapy

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v39i1.28868 ◽

2017 ◽

Vol 39 (1) ◽

pp. 17 ◽

Cited By ~ 3

Author(s):

Mariane Fernandes Ribeiro ◽

Ana Paula Espindula ◽

Alex Abadio Ferreira ◽

Luciane Aparecida Pascucci Sande de Souza ◽

Vicente De Paula Antunes Teixeira

Keyword(s):

Down Syndrome ◽

Muscle Activation ◽

Motor Behavior ◽

Vastus Lateralis ◽

Rectus Femoris ◽

Gluteus Medius ◽

Biceps Femoris ◽

Functional Results ◽

Lower Limbs ◽

Tensor Fasciae Latae

Hippotherapy is a therapeutic method that uses the horse’s movement to achieve functional results in practitioners with Down syndrome (DS), who present motor and neurophysiological changes that affect the musculoskeletal system. Evaluating the motor behavior related to the control and the improvement of muscle activation in practitioners with Down syndrome subjected to hippotherapy. 10 practitioners were divided into two groups: Down Group (DG) – practitioners with DS, and Healthy Group (HG) – practitioners with no physical impairment. The muscles gluteus medius, tensor fasciae latae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius were evaluated by electromyography using gross RMS values, which correspond to muscle activation; the evaluations were performed on the 1st and 10th hippotherapy sessions (frequency: once a week), and after 2 months interval without treatment, they were performed on the 1st and 10th hippotherapy sessions (frequency: twice a week). It was noted that activation of the studied muscles increased with the passing of sessions, regardless the weekly frequency of attendance; however, the period without treatment resulted in reduction of this effect. Practitioners with DS presented satisfactory changes in muscle activation pattern, in learning and in motor behavior during hippotherapy sessions.

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Prolonged standing behaviour in people with joint hypermobility syndrome

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04744-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Alexander Vernon Bates ◽

Alison H. McGregor ◽

Caroline M. Alexander

Keyword(s):

Connective Tissue ◽

Postural Sway ◽

Chronic Widespread Pain ◽

Joint Hypermobility ◽

Quiet Standing ◽

Widespread Pain ◽

Hypermobility Syndrome ◽

Joint Hypermobility Syndrome ◽

Prolonged Standing ◽

Heritable Disorder

Abstract Background Joint Hypermobility Syndrome (JHS) is a rare Heritable Disorder of Connective tissue characterised by generalised joint laxity and chronic widespread pain. Joint Hypermobility Syndrome has a large impact on patients’ day to day activities, and many complain of symptoms when standing for prolonged periods. This study investigates whether people with JHS exhibit the same behaviours to deal with the effects of prolonged standing as people with equal hypermobility and no pain, and people with normal flexibility and no pain. Methods Twenty three people with JHS, 22 people with Generalised Joint Hypermobility (GJH), and 22 people with normal flexibility (NF) were asked to stand for a maximum of 15 min across two force-plates. Fidgets were counted and quantified using a cumulative sum algorithm and sway parameters of the quiet standing periods between fidgets were calculated. Results Average standing time for participants with JHS was 7.35 min and none stood for the full 15 min. All participants with GJH and NF completed 15 min of standing. There were no differences in fidgeting behaviour between any groups. There was a difference in anteroposterior sway (p = .029) during the quiet standing periods. Conclusion There is no evidence to suggest people with JHS exhibit different fidgeting behaviour. Increased anteroposterior-sway may suggest a muscle weakness and strengthening muscles around the ankle may reduce postural sway and potentially improve the ability to stand for prolonged periods.

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