title: Medication, surgery, and physiotherapy among patients with the hypermobility type of Ehlers-Danlos syndrome.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Physical and rehabilitation medicine department and center for medical genetics.
  
  
  METHODS
  Patients with EDS-HT (N=79; 8 men, 71 women) were recruited for this study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Artevelde University College, Ghent, Belgium. Lies.Rombaut@ugent.be
authors.forename: Lies
authors.initials: L
authors.lastname: Rombaut
authors.forename: Fransiska
authors.initials: F
authors.lastname: Malfait
authors.forename: Inge
authors.initials: I
authors.lastname: De Wandele
authors.forename: Ann
authors.initials: A
authors.lastname: Cools
authors.forename: Youri
authors.initials: Y
authors.lastname: Thijs
authors.forename: Anne
authors.initials: A
authors.lastname: De Paepe
authors.forename: Patrick
authors.initials: P
authors.lastname: Calders
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000203:Activities of Daily Living; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000628:therapy; D005260:Female; D006225:Hand / Q000601:surgery; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D012785:Shoulder Joint / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives; D000082:Acetaminophen