{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T06:33:19Z","timestamp":1764311599711,"version":"3.46.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN-2020-04817"],"award-info":[{"award-number":["RGPIN-2020-04817"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011666","name":"Ehlers-Danlos Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011666","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Individuals 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 11 HSD\/hEDS participants (33 \u00b1 14 yrs, 170 \u00b1 6. cm, weight 71 \u00b1 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CoT was significantly higher in HSD\/hEDS compared to CON at all speeds (\n                      <jats:italic>p<\/jats:italic>\n                      = 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 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), significantly poorer foot function (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and significantly higher fatigue severity (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) prior to walking. Despite similar PWS (1.1 \u00b1 0.3 m\u2e31s\n                      <jats:sup>-1<\/jats:sup>\n                      ), Leg pain\/fatigue immediately following walking was significantly higher in HSD\/hEDS compared to CON (group main effect\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 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\n                      <jats:italic>r<\/jats:italic>\n                      &amp;gt; 0.69,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2025.1706912","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T06:29:09Z","timestamp":1764311349000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived quality of life, fatigue and the metabolic cost of walking in generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome"],"prefix":"10.3389","volume":"6","author":[{"given":"Aera J. 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