Medication, surgery, and physiotherapy among patients with the hypermobility type of Ehlers-Danlos syndrome

Arch Phys Med Rehabil. 2011 Jul;92(7):1106-12. doi: 10.1016/j.apmr.2011.01.016. Epub 2011 Jun 2.

Abstract

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.

MeSH terms

  • Acetaminophen / therapeutic use
  • Activities of Daily Living*
  • Adult
  • Analgesics, Non-Narcotic / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Ehlers-Danlos Syndrome / complications
  • Ehlers-Danlos Syndrome / therapy
  • Female
  • Hand / surgery
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Measurement
  • Physical Therapy Modalities / statistics & numerical data*
  • Shoulder Joint / surgery
  • Surveys and Questionnaires
  • Treatment Outcome
  • Wrist Joint / surgery

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antidepressive Agents
  • Hypnotics and Sedatives
  • Acetaminophen

Supplementary concepts

  • Ehlers-Danlos syndrome type 3