Article

The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type
(EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness,
potentially leading to activity limitations. In EDS-HT,
a direct relationship
between muscle strength, proprioception and activity limitations has never been
studied. The objective of the study was to establish the association between
muscle strength and activity limitations and the impact of proprioception on this
association in EDS-HT patients. METHODS: Twenty-four EDS-HT patients were
compared with 24 controls. Activity limitations were quantified by Health
Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise
test (30CRT). Muscle strength was quantified by handheld dynamometry.
Proprioception was quantified by movement detection paradigm. In analyses, the
association between muscle strength and activity limitations was controlled for
proprioception and confounders. RESULTS: Muscle strength was associated with
30CRT (r = 0.67, p = <0.001), 6MWT (r = 0.58, p = <0.001) and HAQ (r = 0.63, p=
<0.001). Proprioception was associated with 30CRT (r = 0.55, p < 0.001), 6MWT (r
= 0.40, p = <0.05) and HAQ (r = 0.46, p < 0.05). Muscle strength was found to be
associated with activity limitations, however, proprioceptive inacuity confounded
this association. CONCLUSIONS: Muscle strength is associated with activity
limitations in EDS-HT patients. Joint proprioception is of influence on this
association and should be considered in the development of new treatment
strategies for patients with EDS-HT. Implications for rehabilitation Reducing
activity limitations by enhancing muscle strength is frequently applied in the
treatment of EDS-HT patients. Although evidence regarding treatment efficacy is
scarce, the current paper confirms the rationality that muscle strength is an
important factor in the occurrence of activity limitations in EDS-HT patients.
Although muscle strength is the most dominant factor that is associated with
activity limitations, this association is confounded by proprioception. In
contrast to common belief proprioception was not directly associated with
activity limitations but confounded this association. Controlling muscle strength
on the bases of proprioceptive input may be more important for reducing activity
limitations than just enhancing sheer muscle strength.

Langue : ANGLAIS