Three-Dimensional Motion of the Shoulder Complex during Activities of Daily Living in Youths with Hypermobile Ehlers-Danlos Syndrome

Research Objectives To investigate the sternoclavicular, acromioclavicular, and glenohumeral joint motion necessary to perform common activities of daily living in youths with hypermobile Ehlers-Danlos syndrome (hEDS). Design Cohort, prospective, cross-sectional. Setting Motion Analysis Lab at the University of Wisconsin-Milwaukee. Participants Five female and 4 male youths (mean±SD age: 14±2.9 years) with hEDS. Interventions Participants completed a single experimental session. Participants performed four unilateral activities of daily living (ADLs): reach across body, reach behind back, comb hair, and drink from cup. A 15-camera Vicon motion capture system recorded three-dimensional thorax and upper extremity motion. Joint angles and ranges of motion were computed for the sternoclavicular, acromioclavicular, and glenohumeral joints. Main Outcome Measures Three-dimensional sternoclavicular, acromioclavicular, and glenohumeral joint motions. Results The sternoclavicular joint moved through both elevation (max: -8±6.5°) and depression (max: 11±4.7°), while maintaining some degree of retraction (max: -44±4.4°) throughout the four ADLs. The acromioclavicular joint maintained some degree of upward rotation (max: 56±8.3°), protraction (max: 62±8.1°), and posterior tilt (max: 28±14.3°) regardless of the activity. Finally, glenohumeral joint motion was the most diverse, requiring it to perform adduction (max: 19±6.4°), abduction (max: -64±11°), internal rotation (max: 19±6.4°), external rotation (max: -91±33°), flexion (max: 55±9.8°), and extension (max: -46±9.2°). Conclusions Although hEDS has the potential to significantly disrupt shoulder complex motion, our results suggest that youths with hEDS can perform certain ADLs largely without operating at extreme shoulder joint positions. Moreover, children with hEDS perform these ADLs using similar scapular and glenohumeral kinematics to that reported for able-bodied individuals. Author(s) Disclosures No conflicts of interest to disclose.