Hamstring Strengthening in Hypermobile Conditions

Effects and Feasibility of Eccentric Hamstring Strengthening in Hypermobility Spectrum Disorders and Hypermobile Ehlers-Danlos Syndrome

The goal of this clinical trial is to determine how strengthening the hamstring muscles affects the knee joint in people living with hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS). The main questions it aims to answer are:

• Does hamstring strengthening reduce the looseness of the knee joint in HSD/hEDS?
• Does hamstring strengthening improve clinical outcomes like pain in people living with HSD/hEDS?

Participants will:

• Attend two exercise classes per week for 12 weeks.
• Visit the laboratory every 4-6 weeks for testing.

Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) affect 1 in 500 people, predominantly females. While exercise is known to be beneficial for HSD/hEDS, the effect of eccentric exercise on passive joint stability, the functional capacity to perform daily activities, and quality of life remains unknown. This clinical trial aims to determine the effects of a 12-week eccentric hamstring strengthening intervention for females with HSD/hEDS on knee joint laxity, performance during walking and stair climbing, and quality of life. This study will have important implications for understanding the impacts of exercise in HSD/hEDS. This can then inform clinical guidance and recommendations around lower limb exercise for this population.

Inclusion Criteria:

• Reported diagnosis of HSD or hEDS by a physician
• Meet the 2017 International Diagnostic Criteria for HSD and hEDS
• Clearance to participant in exercise participation, determined using the Get Active Questionnaire

Exclusion Criteria:

• Other acquired or hereditary connective tissue disorder (i.e., rheumatoid arthritis, Marfan syndrome, etc.)
• Currently experiencing daily knee pain
• Prior knee injury or surgery
• Intra-articular knee injection in the last 12 months
• Currently pregnant