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Benistan K, Foy M, Gillas F, Genet F, Kane M, Barbot F, Vaugier I, Bonnyaud C, Gader N. Effects of compression garments on balance in hypermobile Ehlers-Danlos syndrome: a randomized controlled trial. Disabil Rehabil 2024; 46:1841-1850. [PMID: 37194618 DOI: 10.1080/09638288.2023.2209742] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. METHODS Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. RESULTS Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36-39.23, effect size 0.93) and area (95% CI 146-3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CONCLUSION CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. TRIAL REGISTRATION NCT03359135.
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Affiliation(s)
- Karelle Benistan
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
| | - Malika Foy
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - Fabrice Gillas
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - François Genet
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
- AP-HP, Hôpital Raymond-Poincaré, Service de médecine physique et de réadaptation, Université Paris Saclay, Garches, France
| | - Maimouna Kane
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Frédéric Barbot
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Isabelle Vaugier
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Céline Bonnyaud
- AP-HP, Hôpital Raymond Poincaré, Laboratoire d'analyse du mouvement, Université Paris-Saclay, Garches
- Université de Versailles Saint Quentin en Yvelines, ERPHAN, Versailles, France
| | - Nadra Gader
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
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Benistan K, Pontier B, Leblond C, Flageul O, Le Guicher G, Enjalbert M, Gillas F. The Effectiveness of Compression Garments for Reducing Pain in Non-Vascular Ehlers-Danlos Syndromes: A Prospective Observational Cohort Study. Healthcare (Basel) 2023; 11:1862. [PMID: 37444695 DOI: 10.3390/healthcare11131862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Patients with Ehlers-Danlos Syndrome (EDS) frequently suffer from severe chronic pain. We carried out an observational cohort study to assess the effectiveness of compression garments (CGs) for reducing this pain. Patients with non-vascular EDS were given custom-made Cerecare® CGs during a visit to a specialist clinic (visit V0). They were followed up over 2 years with visits every 6 months (V1-V4). At each visit, pain was assessed for the joints treated with CGs using a visual analogue scale (VAS; 0-100 mm). Additional measures were obtained to assess neuropathic pain (painDETECT questionnaire), proprioception/balance (Berg Balance Scale), and functional independence, amongst others. Data were analyzed for 67 patients with EDS (hypermobile: 91%; classical: 6%; kyphoscoliotic: 3%). For the most painful joint, the mean VAS rating was 71.5 ± 22.8 mm at V0; this decreased to 53.5 ± 25.5 mm at V1 and 45.7 ± 29 mm at V4 (t-tests: p < 0.0001). From V0 to V4, improvements were also seen for pain at the other joints, neuropathic pain, functional independence, proprioception/balance, and the incidence of sprains and dislocations/subluxations, although not all comparisons were statistically significant (p < 0.05 level). These results indicate that CGs may effectively reduce the pain and joint instability in non-vascular EDS patients.
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Affiliation(s)
- Karelle Benistan
- Reference Center for Ehlers-Danlos Syndromes, Raymond Poincaré Hospital, 92380 Garches, France
| | - Bénédicte Pontier
- Génétique Médicale, Estaing University Hospital, 63100 Clermont-Ferrand, France
| | | | | | | | | | - Fabrice Gillas
- Reference Center for Ehlers-Danlos Syndromes, Raymond Poincaré Hospital, 92380 Garches, France
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Foy M, Métay C, Frank M, Denarié N, Adham S, Billon C, Legrand A, Jeunemaitre X, Gillas F, Gaudon K, De Mazancourt P, Mekki A, Carlier R, Benistan K. A severe case of PLOD1-related kyphoscoliotic Ehlers-Danlos syndrome associated with several arterial and venous complications: A case report. Clin Case Rep 2023; 11:e6760. [PMID: 36860721 PMCID: PMC9969762 DOI: 10.1002/ccr3.6760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/25/2022] [Accepted: 12/05/2022] [Indexed: 03/02/2023] Open
Abstract
Kyphoscoliotic Ehlers-Danlos syndrome (kEDS) is a rare genetic disorder combining congenital hypotonia, congenital/early onset and progressive kyphoscoliosis, and generalized joint hypermobility. Vascular fragility is another characteristic of the disease rarely described. We report a severe case of kEDS-PLOD1 with several vascular complications leading to difficulties in disease management.
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Affiliation(s)
- Malika Foy
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculairesGarchesFrance
| | - Corinne Métay
- AP‐HP, Groupe Hospitalier La Pitié‐Salpêtrière‐Charles Foix, Centre de Génétique Moléculaire et Chromosomique, Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaireParisFrance
| | - Michael Frank
- AP‐HP, Hôpital européen Georges Pompidou, Centre de référence des maladies vasculaires rares et service de Génétique, PARCC INSERM UMR970, VASCERN MSA European Reference CentreParisFrance
| | - Nicolas Denarié
- AP‐HP, Hôpital européen Georges Pompidou, Centre de référence des maladies vasculaires rares et service de Génétique, PARCC INSERM UMR970, VASCERN MSA European Reference CentreParisFrance
| | - Salma Adham
- CHU de Montpellier, Hôpital Saint Eloi, Service de Médecine Vasculaire – MontpellierMontpellierFrance
| | - Clarisse Billon
- AP‐HP, Hôpital européen Georges Pompidou, Centre de référence des maladies vasculaires rares et service de Génétique, PARCC INSERM UMR970, VASCERN MSA European Reference CentreParisFrance
| | - Anne Legrand
- AP‐HP, Hôpital européen Georges Pompidou, Centre de référence des maladies vasculaires rares et service de Génétique, PARCC INSERM UMR970, VASCERN MSA European Reference CentreParisFrance,Université de Paris, Faculté de MédecineParisFrance
| | - Xavier Jeunemaitre
- AP‐HP, Hôpital européen Georges Pompidou, Centre de référence des maladies vasculaires rares et service de Génétique, PARCC INSERM UMR970, VASCERN MSA European Reference CentreParisFrance,Université de Paris, Faculté de MédecineParisFrance
| | - Fabrice Gillas
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculairesGarchesFrance
| | - Karen Gaudon
- AP‐HP, Groupe Hospitalier La Pitié‐Salpêtrière‐Charles Foix, Centre de Génétique Moléculaire et Chromosomique, Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaireParisFrance
| | - Philippe De Mazancourt
- AP‐HP, GHU Paris Saclay, Hôpital Ambroise Paré, Laboratoire de BiochimieBoulogne BillancourtFrance
| | - Ahmed Mekki
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, DMU Smart ImagingGarchesFrance
| | - Robert Carlier
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, DMU Smart Imaging, UMR1179 INSERMGarchesFrance
| | - Karelle Benistan
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculaires, UMR1179 INSERMGarchesFrance
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Foy M, de Mazancourt P, Bremond Gignac D, Gillas F, Trigui N, Mekki A, Carlier R, Benistan K. Classical
Ehlers–Danlos
syndrome with severe kyphoscoliosis due to a novel pathogenic variant of
COL5A2. Clin Case Rep 2022; 10:e06338. [PMCID: PMC9703103 DOI: 10.1002/ccr3.6338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/28/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Malika Foy
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculaires Garches France
| | - Philippe de Mazancourt
- AP‐HP, GHU Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Biochimie Boulogne Billancourt France
- INSERM, U1179, Université Versailles Saint‐Quentin‐en‐Yvelines Montigny‐le‐Bretonneux France
| | - Dominique Bremond Gignac
- Ophthalmology Department, AP‐HP, Hôpital Necker‐Enfants Malades CRMR OPHTARA, Paris University Paris France
- INSERM, UMRS1138, Team 17 Centre de Recherche des Cordeliers, Sorbonne Paris Cité University Paris France
| | - Fabrice Gillas
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculaires Garches France
| | - Nawel Trigui
- INSERM, U1179, Université Versailles Saint‐Quentin‐en‐Yvelines Montigny‐le‐Bretonneux France
| | - Ahmed Mekki
- AP‐HP, GHU Paris‐Saclay, Raymond Poincaré Teaching Hospital, DMU Smart Imaging Garches France
| | - Robert Carlier
- INSERM, U1179, Université Versailles Saint‐Quentin‐en‐Yvelines Montigny‐le‐Bretonneux France
- AP‐HP, GHU Paris‐Saclay, Raymond Poincaré Teaching Hospital, DMU Smart Imaging Garches France
| | - Karelle Benistan
- AP‐HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers‐Danlos non vasculaires Garches France
- INSERM, U1179, Université Versailles Saint‐Quentin‐en‐Yvelines Montigny‐le‐Bretonneux France
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Foy M, De Mazancourt P, Métay C, Carlier R, Allamand V, Gartioux C, Gillas F, Miri N, Jobic V, Mekki A, Richard P, Michot C, Benistan K. A novel COL1A1 variant in a family with clinical features of hypermobile Ehlers-Danlos syndrome that proved to be a COL1-related overlap disorder. Clin Case Rep 2021; 9:e04128. [PMID: 34484741 PMCID: PMC8405372 DOI: 10.1002/ccr3.4128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/15/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022] Open
Abstract
COL1-related overlap disorder is a condition, which is not yet considered as part of the 2017 EDS classification. However, it should be investigated as an alternative diagnosis for any patient with hypermobile EDS. This could allow providing appropriate genetic counseling.
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Affiliation(s)
- Malika Foy
- Centre de Référence des Syndromes d'Ehlers‐Danlos Non VasculairesHôpital Raymond PoincaréGarchesFrance
| | - Philippe De Mazancourt
- INSERM U1179Université Versailles Saint‐Quentin‐en‐YvelinesMontigny‐le‐BretonneuxFrance
- Service de Biochimie et Biologie MoléculaireHôpital Ambroise ParéAPHPBoulogne‐BillancourtFrance
| | - Corinne Métay
- Sorbonne Université ‐ Inserm UMRS974Centre de Recherche en MyologieGH Pitié‐SalpêtrièreParisFrance
- AP‐HPCentre de Génétique Moléculaire et ChromosomiqueUF Cardiogénétique et Myogénétique Moléculaire et CellulaireGH Pitié‐SalpêtrièreParisFrance
| | - Robert Carlier
- INSERM U1179Université Versailles Saint‐Quentin‐en‐YvelinesMontigny‐le‐BretonneuxFrance
- APHPGHU Paris‐SaclayDMU Smart ImagingService de radiologie Hôpital Raymond PoincaréGarchesFrance
| | - Valérie Allamand
- Sorbonne Université ‐ Inserm UMRS974Centre de Recherche en MyologieGH Pitié‐SalpêtrièreParisFrance
- Unit of Muscle BiologyDepartment of Experimental Medical ScienceLund UniversityLundSweden
| | - Corine Gartioux
- Sorbonne Université ‐ Inserm UMRS974Centre de Recherche en MyologieGH Pitié‐SalpêtrièreParisFrance
| | - Fabrice Gillas
- Centre de Référence des Syndromes d'Ehlers‐Danlos Non VasculairesHôpital Raymond PoincaréGarchesFrance
| | - Nawel Miri
- Service de Biochimie et Biologie MoléculaireHôpital Ambroise ParéAPHPBoulogne‐BillancourtFrance
| | - Valérie Jobic
- AP‐HPCentre de Génétique Moléculaire et ChromosomiqueUF Cardiogénétique et Myogénétique Moléculaire et CellulaireGH Pitié‐SalpêtrièreParisFrance
| | - Ahmed Mekki
- APHPGHU Paris‐SaclayDMU Smart ImagingService de radiologie Hôpital Raymond PoincaréGarchesFrance
| | - Pascale Richard
- AP‐HPCentre de Génétique Moléculaire et ChromosomiqueUF Cardiogénétique et Myogénétique Moléculaire et CellulaireGH Pitié‐SalpêtrièreParisFrance
| | - Caroline Michot
- INSERM UMR_S1163Institut des Maladies Génétiques ImagineHôpital Necker Enfants MaladesParisFrance
- Centre de Référence des Syndromes d'Ehlers‐Danlos non VasculairesHôpital Necker Enfants MaladesParisFrance
| | - Karelle Benistan
- Centre de Référence des Syndromes d'Ehlers‐Danlos Non VasculairesHôpital Raymond PoincaréGarchesFrance
- INSERM U1179Université Versailles Saint‐Quentin‐en‐YvelinesMontigny‐le‐BretonneuxFrance
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6
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Gillas F, Mekki A, Foy M, Carlier R, Benistan K. Prevalence of Scoliosis in Hypermobile Ehlers-Danlos Syndrome. EMJ 2021. [DOI: 10.33590/emj/20-00284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective: The main purpose of this study was to evaluate the prevalence, form, and severity of scoliosis in a population of adults meeting the 2017 criteria for hypermobile Ehlers-Danlos syndrome (hEDS). The second objective was to compare the prevalence of scoliosis versus other criteria at initial hEDS diagnosis.
Methods: A retrospective study looking at the frequency and severity of scoliosis in adults (N=28) meeting the 2017 diagnostic criteria for hEDS through analysis of a full spine EOS® X-ray (EOS imaging, Paris, France) performed at the initial diagnosis. Severity was defined by the Cobb angle.
Results: At the initial diagnosis, the mean age was 30.1 years (standard deviation [SD]: ±10.18 years). Twenty-nine percent (n=8/28) of patients fulfilling hEDS criteria presented with scoliosis. Thirty-two percent (n=9/28) of patients had scoliotic inflection and 39% (n=11/28) had no scoliosis. Scoliosis was mild-to-moderate with a mean Cobb angle of 13.6° (SD: ±3.5°). None of the patients had severe scoliosis requiring surgery. Compared to the 2017 diagnostic criteria, it is noteworthy that scoliosis prevalence in this present study population ranks at the level of the most frequent ones.
Conclusion: This study provides interesting information regarding frequency of scoliosis and scoliotic inflection in a group of patients with hEDS. Although the patients did not present with severe forms of scoliosis at initial diagnosis, the results highlight the importance of systematically looking for scoliosis in adult and young patients, in order to follow progression and ensure appropriate management.
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Affiliation(s)
- Fabrice Gillas
- Department for Non-vascular Ehlers-Danlos Syndromes, Raymond Poincaré Hospital, Garches, France
| | - Ahmed Mekki
- DMU Smart Imaging, Department of Radiology, Raymond Poincaré Hospital, Garches, France
| | - Malika Foy
- Department for Non-vascular Ehlers-Danlos Syndromes, Raymond Poincaré Hospital, Garches, France
| | - Robert Carlier
- DMU Smart Imaging, Department of Radiology, Raymond Poincaré Hospital, Garches, France; INSERM U1179, Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
| | - Karelle Benistan
- Department for Non-vascular Ehlers-Danlos Syndromes, Raymond Poincaré Hospital, Garches, France; INSERM U1179, Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France
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Michetti P, Weinman J, Mrowietz U, Smolen J, Schremmer D, Tundia N, Gillas F, Selenko-Gebauer N. FRI0198 Multi-Country, Cross-Sectional Study to Determine Patient-Specific and General Beliefs towards Medication and their Treatment Adherence to Selected Systemic Therapies in 6 Chronic Immune-Mediated Inflammatory Diseases (ALIGN). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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