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Abstract

Objective

To investigate balance, gait, falls, and fear of falling in patients with the hypermobility type of Ehlers-Danlos syndrome (EDS-HT).

Methods

Twenty-two women with EDS-HT and 22 sex- and age-matched healthy control subjects participated in the study. Each subject performed the modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and the Tandem Stance test (TS) on an AccuGait force platform to assess balance by center of pressure–based postural sway measures. The GAITRite walkway system was used to record spatial–temporal gait variables during 3 walking conditions (single task, cognitive task, and functional task). Data about fall frequency and circumstances were collected by retrospective recall, and fear of falling was assessed by the modified Falls Efficacy Scale.

Results

Compared with healthy subjects, EDS-HT subjects showed significantly impaired balance, reflected by increased sway velocity, mediolateral and anteroposterior sway excursion, and sway area during mCTSIB and TS. Gait velocity, step length, and stride length were significantly smaller during all walking conditions, and a significant dual-task–related decrement was found for gait velocity, step and stride length, and cadence in the EDS-HT subjects compared to the control group. Ninety-five percent of the patients fell during the past year, and some fear of falling was measured.

Conclusion

To our knowledge, this study is the first to establish that EDS-HT is associated with balance and gait impairments, increased fall frequency, and poorer balance confidence, implying a decrease in the safety of standing in everyday life situations. Whether these deficits can be improved by appropriate exercise programs needs to be addressed in future research.