Data Sheet 2_Perceived quality of life, fatigue and the metabolic cost of walking in generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome.pdf

IntroductionIndividuals with hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) often experience chronic pain, leg fatigue and/or pain, which may contribute to a higher metabolic cost of walking. How these subjective measures may manifest in an elevated metabolic cost of transport and perceived pain at varying walking speeds remains to be evaluated.
MethodsWe recruited 11 HSD/hEDS participants (33 ± 14 yrs, 170 ± 6. cm, weight 71 ± 11 kg) and 11 age- and sex-matched controls. Self-reported subjective outcome measures of health-related quality of life, fatigue severity, and foot function were evaluated prior to treadmill walking using the 36-Item Short Form Health Survey (SF-36) and the Fatigue Severity Scale (FSS). Participants also rated their self-perceived leg pain/fatigue following 3 x 6 min of treadmill walking at 80%, 100% and 120% of preferred walking speed (PWS). Cost of transport (CoT) was calculated from indirect calorimetry.
ResultsCoT was significantly higher in HSD/hEDS compared to CON at all speeds (p = 0.034). CoT was significantly higher at 80% PWS compared to both 100% and 120% PWS in HSD/hEDS. HSD/hEDS reported significantly poorer health outcomes across all SF-36 domains (p < 0.05), significantly poorer foot function (p < 0.001) and significantly higher fatigue severity (p < 0.001) prior to walking. Despite similar PWS (1.1 ± 0.3 m⸱s-1), Leg pain/fatigue immediately following walking was significantly higher in HSD/hEDS compared to CON (group main effect p < 0.001) and increased with speed in HSD/hEDS (p = 0.011). The physical function domain was significantly related post-walking leg pain/fatigue, and perceived energy prior to walking (all r > 0.69, p < 0.001).
DiscussionThese results have important implications for exercise prescription in individuals with HSD/hEDS whose CoT is higher during walking, which may exacerbate already elevated symptoms of pain and fatigue.