Hamstring Strengthening in Hypermobile Conditions

Condition(s) studied

Investigational drug(s) / intervention(s)

Progressive resistance exercise with an emphasis on eccentric hamstring loading.: The exercise intervention consists of a 12-week supervised lower limb strengthening program focused on eccentric hamstring loading. This program is adapted from a lower limb progressive resistance training protocol that was well-tolerated and effective in people with HSD/hEDS. Each exercise session will start with a 10-minute aerobic warm up. This will be followed by the lower limb strengthening exercises, and a 5-minute aerobic cooldown. The lower limb exercises will include forward lunges and seated machine weights (leg press, leg extension, leg curl, calf raise). At weeks 6-11, eccentric hamstring loading will be initiated by utilizing the 2:1 technique of two limbs performing concentric action at once and then a single limb performing the eccentric action in a seated leg curl machine. This is an established eccentric loading protocol for the hamstring muscle group.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Knee Joint Laxity — Measured at all 6 outcome assessments (baseline, 4, 8, 12, 18, and 24 weeks).
  Anterior knee joint laxity measured in millimeters using a KT-2000 Knee Ligament Arthrometer at 67N, 89N, and 133N of applied force, as well as maximum displacement. Posterior knee joint laxity will be assessed at 67N of applied force. Changes in knee joint laxity at each level of applied force will be assessed from baseline to 4, 8, 12, 18, and 24 weeks after baseline.

Trial sites (1)

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