Walking and running in people who are hypermobile: A scoping review

Objective

Impairments in connective tissue, skeletal muscle and neurological function contribute to gait dysfunction in people with generalised joint hypermobility (GJH), leading to significant activity limitation across the lifespan. Understanding differences between hypermobile and non-hypermobile gait may lead to more effective assessment and treatment strategies. The objectives of this scoping review were: 1) To synthesise and appraise the evidence relating to walking and running in people who are hypermobile, 2) identify gaps in the literature, and 3) provide direction for future research.

Methods

A search of 6 electronic databases was conducted in April 2024. Papers were assessed for eligibility by 2 reviewers and were included if they met the following criteria: 1) Include a population with generalised joint hypermobility, and 2) report outcomes relating to walking or running gait. Study quality was assessed using a modified version of the Downs and Black quality appraisal checklist.

Results

The search revealed 3543 papers. Following title and abstract screening, 50 papers were included in the final review. On quality appraisal, observational papers rated from poor to good, while interventional papers rated from moderate to good. Studies of gait analysis reporting spatiotemporal, kinematic, and kinetic results were most common, followed by functional measures and outcomes relating to interventions. A narrative analysis was conducted as the diversity of the studies prevented meta-analysis.

Conclusion

No papers related to hypermobile running gait. In studies of walking, heterogeneity in inclusion criteria and outcome measures limited comparability between studies. Of the numerous statistically significant outcomes presented in the 51 papers, clinical relevance was rarely reported and was found to be difficult to measure.