Home-based exercise therapy for treating shoulder instability in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders. A randomized trial

Spanhove, Valentien; Wandele, Inge De; Malfait, Fransiska; Cools, Ann

doi:10.1080/09638288.2022.2076932

Cited by 8 publications

(6 citation statements)

References 48 publications

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“…Function was assessed using 4 valid, reliable, and responsive outcome measures that examine different dimensions of upper extremity function. The average baseline WOSI score for our study was 1,185 which correlates closely with other current research studying patients with EDS, adding validity to our results ( 31 ). In both the control and experimental group, there was significant improvement in function from pre-intervention to 48 h post tape ( p < 0.001) with large effect sizes ( ƞ p 2 = .517–.719) for all outcome measures.…”

Section: Discussionsupporting

confidence: 90%

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome

et al. 2023

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BackgroundEhlers-Danlos Syndrome (EDS) is a group of inherited connective tissue disorders which predominantly affects women and has a prevalence as high as 1 in 5,000 individuals. Hypermobile EDS (hEDS) is the most common subtype of EDS and is characterized by multi-joint pain, particularly in large joints such as the shoulder. Physical therapy is often utilized to address the pain, physical impairments, and functional loss in patients with EDS. Kinesiology Tape (KT) is an intervention commonly used by physical therapists for treating shoulder pain and dysfunction. Studies related to the effectiveness of KT in patients with shoulder pain is equivocal and there are a lack of studies specifically studying the effects of KT in an EDS population.PurposeThe purpose of this study was to assess the efficacy and short-term effects of two different KT techniques on shoulder pain and function in individuals with hEDS and shoulder pain.MethodsParticipants were recruited from EDS support groups in the New England area of the United States; were diagnosed with hEDS by their physician; and had shoulder pain. Baseline demographic information was obtained for each participant followed by completion of 4 patient reported outcome (PRO) measures: the Upper Extremity Functional Index, QuickDASH (Disabilities of the Arm, Shoulder, & Hand), Shoulder Pain and Disability Index, and the Western Ontario Shoulder Instability Index. Current pain level, average pain over the past 24 h, and worst pain over the past 24 h were recorded using the numeric pain rating scale (NPRS). Subjects were randomly assigned to receive either an experimental shoulder KT procedure or a control shoulder taping. Immediately after taping, the NPRS was reassessed. Subjects then returned 48 h later to repeat the NPRS and PRO measures.ResultsThere was no significant difference between the experimental and control tape groups for any outcome measure. There was a significant improvement from pre-taping to 48-hours post taping for each of the 4 PRO measures with large effect sizes (p < 0.001; ƞp2 = .517–.719). Likewise, average, and worst pain over the last 24 h significantly improved with large effect sizes over the same period (p = 0.005; ƞp2 = .225 and p < 0.001; ƞp2 = .382, respectively). Current NPRS levels significantly improved from pre-tape to immediately post-tape (p = .023, ƞp2 = .131) and was maintained through the 48-hour follow up, although no further improvement was seen.ConclusionKT is an inexpensive and relatively safe intervention that is easy to apply and can offer temporary improvements in pain and function for patients with EDS and shoulder pain.

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Section: Discussionsupporting

confidence: 90%

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome

et al. 2023

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“… 28 Despite observations in the current study that TrA appears impaired in adults with hypermobility, we are unaware of any studies that investigated the efficacy of physical therapy specifically targeting TrA to improve spinal segmental stability in this susceptible population group. This may in part be explained by prior observations that reductions in pain intensity in people with hypermobility are similar between joint targeted therapy that is meant to improve the stability of specific joints 29 and a generalised exercise programme that improves general muscle strength and cardiovascular condition. 30 Regardless, given the observations in our current study, we contend that the efficacy of joint targeted therapy on lateral abdominal muscle function warrants investigation in adults with hypermobility.…”

Section: Discussionmentioning

confidence: 95%

Lateral abdominal muscles of adults with hypermobility may be partially impaired during contraction

Mitchell

Johnson

Adams

et al. 2022

BMJ Open Sport Exerc Med

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BackgroundMuscle function may be impaired in people with generalised hypermobility, yet prior studies have primarily focused on muscles within the extremities. We aimed to examine changes in lateral abdominal muscle (transversus abdominis (TrA) and the external (EO) and internal abdominal obliques (IO)) thickness and length during contraction between participants with and without hypermobility.MethodsThis cross-sectional study examined 12 participants with hypermobility and 12 age-matched, sex-matched, height-matched and weight-matched participants without hypermobility. The Beighton and Belavy-Owen-Mitchell score assessed systemic hypermobility. Muscle thickness and length were measured via panoramic ultrasound scans at rest and during contraction.ResultsWhen compared with rest across all lumbar levels (L1–L5), contraction produced a lesser increase in TrA thickness (β=0.03, p=0.034) for participants with hypermobility compared with control. No group-by-condition interaction was observed for TrA length across all lumbar levels (L1–L5; p=0.269). Contraction produced a greater decrease in EO thickness (β=0.08, p=0.002) at L3 only for participants with hypermobility compared with control. No group-by-condition interactions were observed for IO thickness.ConclusionParticipants with hypermobility had partially impaired lateral abdominal muscle function given a lesser ability to increase TrA muscle thickness during contraction compared with controls.

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“…Thus, the high frequency of comorbidities in chronic illnesses like chronic fatigue syndrome or hEDS/HSD present challenges for researchers trying to identify primary causes and effective treatments. Another Each specialist contributes unique expertise, perspectives and interventions that collectively aim to improve patients' quality of life by broadly targeting their multiple sources of suffering (Atwell et al, 2021;Demes et al, 2020;Estrella & Frazier, 2023;Spanhove et al, 2023;Yew et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…A typical multidisciplinary team should include medical geneticists to confirm diagnosis, provide genetic counseling, and identify associated conditions; rheumatologists to evaluate and manage joint pain, instability, and other orthopedic issues; pain specialists to develop pain management strategies; physiotherapists to develop tailored exercise programs that minimize joint strain; neurologists to evaluate neurological symptoms and provide treatment for conditions such as headaches and neuropathic pain; psychiatrists to diagnose and medically manage mental health conditions through pharmacological interventions; psychotherapists and psychologists to develop coping strategies and lifestyle interventions for managing anxiety, depression, and other mental health challenges; gastroenterologists to assess and treat gastrointestinal issues such as dysmotility, nausea, vomiting, and abdominal pain; nutritionists to recommend dietary changes that may alleviate symptoms and promote overall health; hematologists to evaluate and manage easy bruising and excessive bleeding; and cardiologists to monitor for signs of vascular abnormalities, heart valve problems, and rhythm issues. Each specialist contributes unique expertise, perspectives and interventions that collectively aim to improve patients' quality of life by broadly targeting their multiple sources of suffering (Atwell et al, 2021; Demes et al, 2020; Estrella & Frazier, 2023; Spanhove et al, 2023; Yew et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, for physicians treating these patients, the principles and types of multidisciplinary management, including the identification of the JHM‐associated comorbidities that often are more debilitating than joint symptoms, are essentially the same for hEDS and HSD, as both conditions require awareness, recognition, validation, and care (Anderson & Lane, 2021; Atwell et al, 2021; Bennett et al, 2022; Demes et al, 2020; Estrella & Frazier, 2023; Robbins, 2022; Spanhove et al, 2023; Yew et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

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Looking back and beyond the 2017 diagnostic criteria for hypermobile Ehlers‐Danlos syndrome: A retrospective cross‐sectional study from an Italian reference center

Ritelli,

Chiarelli,

Cinquina

et al. 2023

American J of Med Genetics Pt A

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The most common conditions with symptomatic joint hypermobility are hypermobile Ehlers‐Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). Diagnosing these overlapping connective tissue disorders remains challenging due to the lack of established causes and reliable diagnostic tests. hEDS is diagnosed applying the 2017 diagnostic criteria, and patients with symptomatic joint hypermobility but not fulfilling these criteria are labeled as HSD, which is not officially recognized by all healthcare systems. The 2017 criteria were introduced to improve diagnostic specificity but have faced criticism for being too stringent and failing to adequately capture the multisystemic involvement of hEDS. Herein, we retrospectively evaluated 327 patients from 213 families with a prior diagnosis of hypermobility type EDS or joint hypermobility syndrome based on Villefranche and Brighton criteria, to assess the effectiveness of the 2017 criteria in distinguishing between hEDS and HSD and document the frequencies of extra‐articular manifestations. Based on our findings, we propose that the 2017 criteria should be made less stringent to include a greater number of patients who are currently encompassed within the HSD category. This will lead to improved diagnostic accuracy and enhanced patient care by properly capturing the diverse range of symptoms and manifestations present within the hEDS/HSD spectrum.

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Home-based exercise therapy for treating shoulder instability in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders. A randomized trial

Cited by 8 publications

References 48 publications

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome

Evaluating the effects of two different kinesiology taping techniques on shoulder pain and function in patients with hypermobile Ehlers-Danlos syndrome

Lateral abdominal muscles of adults with hypermobility may be partially impaired during contraction

Looking back and beyond the 2017 diagnostic criteria for hypermobile Ehlers‐Danlos syndrome: A retrospective cross‐sectional study from an Italian reference center

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