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Dynamic Stability Exercises in Patients With Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder

Not Applicable
Completed
Conditions
Hypermobile Ehlers-Danlos Syndrome
Hypermobility Syndrome
Interventions
Behavioral: Dynamic stability exercises
Registration Number
NCT05800262
Lead Sponsor
University Hospital, Linkoeping
Brief Summary

Background:

Symptomatic hypermobility may lead to a number of restrictions in daily life. So far, there is a lack of effective treatments. A whole-body dynamic stability exercise intervention targets to stimulate the dynamic stability and activation of the proprioceptive system and thereby intends to improve patients' health. The aim of the current study was to examine the feasibility, acceptability and impact of a whole-body dynamic stability exercise intervention in patients with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder.

The aim of the current study was to examine the feasibility, acceptability and impact of a dynamic stability exercise intervention in patients with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder.

Methods:

This is a mixed-methods feasibility study. Fifteen patients (14 women and 1 man) with hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorder and chronic pain were recruited from two pain specialist clinics in the South-East of Sweden. A dynamic stability exercise program for daily home-exercise was applied during five physiotherapist led sessions distributed over seven weeks. Patient reported outcome measures (PROMs) included pain and function, psychological well-being and quality of life. The clinical tests included walking and balance. Through qualitative interviews patients and physiotherapists described their experiences of the assessments and intervention. Assessments were done at baseline, after the intervention, and at the 3-month follow-up.

Detailed Description

The specific research questions are:

1. Do retention rates, adherence rates and adverse events allow continuation to a large scale RCT?

2. What are the tendencies of impact of the exercise program on pain, function, psychological well-being and quality of life?

3. Which of the outcome measures used are appropriate and acceptable?

4. What are the patients' and physiotherapists' experiences of the exercise program and protocol.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
15
Inclusion Criteria

Inclusion criteria were adults aged 18 to 67 years old, with generalized hypermobility (castori. A framework), persistent pain (i.e. longer than three months) in at least two of four quadrants of the body and ability to perform the exercises.

Exclusion Criteria

Exclusion criteria were cancer-related pain, underlying neurological disease, presence of severe psychiatric disorders, known substance abuse, patients in the process of finding optimal medication as well as patients with previous experience of similar exercises.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Dynamic stability exerciseDynamic stability exercisesA dynamic stability exercise program for daily home-exercise was applied during five physiotherapist led sessions distributed over seven weeks.
Primary Outcome Measures
NameTimeMethod
Identification of suitable measures for a forthcoming RCTNine months

Qualitative and quantitative evaluation through secondaty outcome measures and qualitative interviews with patients and physiotherapists

Secondary Outcome Measures
NameTimeMethod
Pain numeric rating scale6 months

Rating of mean pain last week

Functional Rating Index6 months

Disability regarding daily activities

Orthostatic Hypotension Questionnaire6 months

Assessment of symptoms and daily activity in relation to orthostatic hypotension. 10 items.

Arthritis Self-efficacy scale6 months

Twenty items divided into three sub-scales for self-efficacy for physical function, other symptoms and pain.

Stress and Crisis Inventory-936 months

Thirty-five items on physical and psychological symptoms that can be clinical manifestations of stress.

Multidimensional Fatigue Inventory 206 months

Five subscales measuring general fatigue, physical fatigue, reduced motivation, reduced activity and mental fatigue.

Item 19 was removed according to Hagelin (2009).

Tampa Scale for Kinesiophobia6 months

Questionnaire measuring kinesiophobia, 17 items.

Bruininks-Oseretsky Test of Motor Proficiency 26 months

Nine tasks testing balance

Timed up and go6 months

Mobility, balance, walking ability and fall risk in older adults

European Quality of Life questionnaire (EQ-5D-3L)6 months

Health related quality of life

Wii balance test using a Wii Balance Board6 months

Balance test. Centre of pressure path length, anterio-posterior and medio-lateral sway measured standing on two feet with eyes open and eyes closed, standing on dominant foot and on non-dominant foot with eyes open. Tests performed according to Schmidt (2017), but during 60 seconds instead of 30 seconds.

2-minute walk test6 months

Walking ability

Berg balance scale6 months

14 tasks common in daily activities testing balance

Trial Locations

Locations (2)

Samrehab Smärtenheten, the Hospital of Västervik

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Västervik, Kalmar Län, Sweden

Pain and rehabilitation center, University Hospital of Linkoping.

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Linköping, Östergötland, Sweden

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