Ankle‐foot problems significantly impact daily functioning in patients with hypermobile Ehlers‐Danlos syndrome and Hypermobility Spectrum Disorder (hEDS/HSD). Therefore, this study aims to identify alterations in multi‐segment ankle and foot kinematics during gait and assessing foot function and pain in these patients. Foot function and pain were assessed using the Visual Analogue Scale (VAS)‐scores, the Margolis Pain Diagram, and the Foot Function Index (FFI).

Levels of pain and foot dysfunction were significantly higher in subjects with hEDS/HSD (p<0.001). Kinematic curve analyses provide evidence for a hypermobile first ray, represented by a significantly increased eversion position of the medial forefoot during the stance phase (p<0.001) in subjects with hEDS/HSD compared to controls. Besides, significantly more dorsiflexion was found in the medial and lateral forefoot and the rearfoot (p<0.001). At the midfoot, increased plantar flexion (p<0.001) and at the level of the hallux a decreased dorsiflexion (p=0.037) and increased inversion (p<0.001) and abduction (p=0.016) were found in subjects with hEDS/HSD.

In conclusion, this study is the first to apply a multi‐segment foot model during gait in hEDS/HSD, which confirms the characteristic hypermobility throughout the foot, especially the hypermobile first ray.