Home-based exercise therapy for treating shoulder instability in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders. A randomized trial
Abstract
Purpose To investigate the effectiveness of two home-based exercise programs for treating multidirectional shoulder instability (MDI) in patients diagnosed with Hypermobile Ehlers-Danlos syndrome (hEDS) or Hypermobility Spectrum Disorders (HSD).Methods Twenty-one hEDS/HSD patients with MDI were recruited from the Center for Medical Genetics of the Ghent University Hospital. Patients were randomly assigned to either the experimental or the control group. Both groups received a 6-month home-based exercise program. The primary outcome measure was the Western Ontario Shoulder Index (WOSI). Secondary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH), Tampa Scale for Kinesiophobia (TSK), Patient-Specific Functional Scale (PSFS), Global Rating of Change (GROC), and pain pressure thresholds. Outcomes were assessed at baseline, after 6 weeks, 12 weeks, and 24 weeks.Results Significant main effects for time were observed for all questionnaires, except for the TSK (p = 0.12). Patients improved 240 and 325 points on the WOSI after 12 (p = 0.02) and 24 weeks (p = 0.001), respectively. Additionally, patients improved 8.6 points on the DASH (p = 0.002), 4.3 points on the PSFS (p = 0.01), and 1.02 points on the GROC (p = 0.001) after 24 weeks.Conclusion No significant differences were found between group A and B. Both home-based exercise programs led to significant improvements in shoulder function. IMPLICATIONS FOR REHABILITATIONHome-based exercise therapy may be effective for treating MDI in the hEDS/HSD population.Home-based training is beneficial for improving shoulder function, but a multidisciplinary, supervised approach might be more effective for altering kinesiophobia in this patient population.
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A randomized trial of 21 patients with multidirectional shoulder instability in HSD/hEDS found home-based exercise programs were beneficial for improving shoulder function using several validated indices.
“A randomized trial of 21 patients assessing multidirectional shoulder instability in HSD/hEDS patients found home-based exercise programs were beneficial for improving shoulder function using several different validated indices.[62]”
From Hypermobility spectrum disorders: A review (2023) · cites this paper as [62]
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- Authors
- Spanhove, V., De Wandele, I., Malfait, F., Calders, P., & Cools, A.
- Affiliations
- Ghent University (BE)
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Ghent University Hospital (BE)
- Corresponding author
- Spanhove, Valentien
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2022-05-24
- Volume
- 45
- Issue
- 11
- Pages
- 1811-1821
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W4281381462
- Cited by
- 20
- References
- 48
- Citations by year
- 2026: 7 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 1
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- Research Foundation Flanders
- The Special Research Fund of Ghent University (BOF17/DOC/220)
- Topics
- Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Keywords
- home-based exercise therapy, multidirectional shoulder instability, hypermobile Ehlers-Danlos syndrome, hypermobility spectrum disorders, shoulder function, kinesiophobia, pressure pain threshold, DASH, Patient-Specific Functional Scale
- MeSH terms
- Blindness, Ehlers-Danlos Syndrome, Exercise Therapy, Humans, Joint Instability, Shoulder, Shoulder Joint
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