Alterations of the hip total joint moment occur during walking in individuals with Marfan syndrome

Background: Marfan Syndrome is an inherited connective tissue disorder associated with musculoskeletal weakness, ligamentous laxity, and lower extremity joint pain. Approximately 46 % of individuals with Marfan Syndrome report hip-related pain yet the underlying alterations that occur in hip joint moments during gait in the Marfan population is not well understood. The purpose of this study was to assess the hip total joint moment during walking in individuals with Marfan Syndrome compared to healthy controls. Methods: Overground 3D gait analysis at a fixed walking speed was conducted for eighteen individuals with Marfan Syndrome and eighteen sex and BMI matched, asymptomatic controls. The total joint moment was calculated as the square root of the sum of the squared planar internal sagittal, frontal, and transverse plane hip moments across the stance phase. Between group differences in peak hip total joint moment and the planar contributions to the peak hip total joint moments during the first and second halves of stance were assessed using an analysis of covariance. Findings: Compared to the control group, the Marfan group walked with greater first peak total hip joint moments (p = 0.01), greater sagittal plane percent contribution (p = 0.03), and greater frontal plane moments (p = 0.02), and frontal plane contributions (p = 0.02) to the hip total joint moment in the first and second half of stance. Interpretation: Higher internal abduction moments at the first and second peak total joint moment may serve as a biomechanical target for gait interventions to reduce hip joint loading that may be associated with hip-related pain in the Marfan population.