title: Postural analysis in a pediatric cohort of patients with Ehlers-Danlos Syndrome: a pilot study.
abstract: BACKGROUND
  The Ehlers-Danlos Syndrome (EDS) is a rare disorder affecting the connective tissue. EDS patients may suffer of proprioception and balance impairment but all the studies dealing with such symptoms have been addressed to adult subjects. The Study of such impairment in younger patients may lead to a better awareness of own motor abilities and to a focused rehabilitative intervention. Therefore, our work aims to assess the occurrence of these alterations in a pediatric cohort of EDS patients.
  
  
  METHODS
  The Research was designed as a cross-sectional study with a matching control group and performed on a pediatric cohort of 12 subjects with Ehlers-Danlos Syndrome (Classic and Hypermobility type) and on 12 healthy controls, during a follow-up visit at the Department of Pediatrics and at the Rehabilitation Unit of the Foundation IRCCS Policlinico San Matteo, in Pavia from April 2015 to October 2015. A square forceplatform was used to obtain the CoP (center of pressure) displacement during quiet standing during an open and a closed eyes trials. The comparisons between EDS and control group were performed using a t-test for independent data. P<0.05 was considered statistically significant. All tests were two-sided.
  
  
  RESULTS
  All the postural parameters considered raised at closed eyes, no significant modifications without vision were found only for the standard deviation along the antero-posterior (AP) axis for the two groups. Both at open eyes and at closed eyes, Patients with EDS showed the postural parameters significantly greater than controls (P≤0.05) and this observation was most notably for the Sway.
  
  
  CONCLUSIONS
  According to our results, a planned monitoring of age-related changes in postural parameters of patients with EDS could be really interesting to provide a perspective of the development of postural control in these patients. In fact, considering our results, it could be interesting to apply rehabilitative strategies to enhance motor coordination and postural reflexes so improving their postural control as soon as possible. Further studies about the postural control in EDS children and adolescents are required to confirm our results.
authors.affiliation: Unit of Physical Medicine and Rehabilitation, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Lisi
authors.affiliation: Unit of Physical Medicine and Rehabilitation, University of Pavia, Pavia, Italy - serenamonteleone@yahoo.it.
authors.forename: Serena
authors.initials: S
authors.lastname: Monteleone
authors.affiliation: Unit of Clinical Epidemiology and Biometric, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.affiliation: Department of Pediatrics, S. Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy.
authors.forename: Berardo
authors.initials: B
authors.lastname: Rinaldi
authors.affiliation: Unit of Physical Medicine and Rehabilitation, S. Matteo Polyclinic, IRCCS and Foundation, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Natali
authors.affiliation: Department of Pediatrics, S. Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Savasta
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004535:Ehlers-Danlos Syndrome / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*