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Medication, Surgery, and Physiotherapy Among Patients With the Hypermobility Type of Ehlers-Danlos Syndrome

      Abstract

      Rombaut L, Malfait F, De Wandele I, Cools A, Thijs Y, De Paepe A, Calders P. Medication, surgery, and physiotherapy among patients with the hypermobility type of Ehlers-Danlos syndrome.

      Objectives

      To describe medication use, surgery, and physiotherapy, and to examine the effect of these treatment modalities on functional impairment and amount of complaints among patients with the hypermobility type of Ehlers-Danlos syndrome (EDS-HT).

      Design

      Cross-sectional study.

      Setting

      Physical and rehabilitation medicine department and center for medical genetics.

      Participants

      Patients with EDS-HT (N=79; 8 men, 71 women) were recruited for this study.

      Interventions

      Not applicable.

      Main Outcome Measures

      Patients filled out questionnaires regarding type of complaints, medication use, surgery, physiotherapy, and outcome of treatment. Functional impairment in daily life was measured by the Sickness Impact Profile. Pain severity was assessed with visual analog scales.

      Results

      Patients reported a large number of complaints, a considerable presence of severe pain, and a clinically significant impact of disease on daily functioning. Most patients (92.4%) used medications, among which analgesics were the most prevalent. Fifty-six patients (70.9%) underwent surgery, including mainly interventions of the extremities and abdomen. Forty-one patients (51.9%) are currently enrolled in a physical therapy program, mainly comprising neuromuscular exercises, massage, and electrotherapy. Patients with a high consumption of analgesics, who visited the physiotherapist, or who underwent surgery had a higher dysfunction in daily life. Only 33.9% of the patients who underwent surgery and 63.4% of patients in physical therapy reported a positive outcome.

      Conclusions

      Patients with EDS-HT have numerous complaints and an impaired functional status that strongly determine their high rate of treatment consumption. The outcome of surgical and physiotherapy treatment is disappointing in a large percentage, which illustrates a strong need for evidence-based therapy.

      Key Words

      List of Abbreviations:

      EDS (Ehlers-Danlos syndrome), EDS-HT (hypermobility type of EDS), NSAIDs (nonsteroidal anti-inflammatory drugs), SIP (Sickness Impact Profile), TENS (transcutaneous electrical nerve stimulation), VAS (visual analog scale), WHO (World Health Organization)
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