Session Information
Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus
Session Type: Abstract Submissions (ACR)
Background/Purpose
Postural instability was found in several functional disorders including dyslexia, chronic pain and fibromyalgia. Furthermore, the link between vertical heterophoria (VH) and postural control is now clearly established. EDS-HT patients shared symptoms usually encountered in patients presenting postural instability.
Methods
Aim : To assess the presence of postural instability and the role of vertical heterophoria among patients suffering from EDS-HT.
Design of study : 30 patients meeting the Villefranche criteria for diagnosis of EDS-HT (generalized joint hypermobility, skin involvement, recurring joint dislocations, chronic joint/limb pain and positive family history) were prospectively examinated. Their postural performance was compared to that of 15 healthy subjects.
Methods : To measure postural instability, we used a force platform. The surface of the center of pressure (CoP) excursions, the standard deviations of lateral (SDx) and antero-posterior (SDy) body sways and the variance of speed were recorded. The surface area was measured with confidence ellipse including 90% of the CoP positions sampled, eliminating the extreme points. Vertical heterophoria (VH) was qualitatively detected with Maddox’ rod. Pain was evaluated using a subjective visual analogical scale (VAS) of 10 cm validated for chronic pain. Fatigue severity scale (FSS) was used.
Results
Among the EDS-HT patients the mean VAS score was 67 mm. 84% had a FFS > 6. All these patients presented with symptoms of muscle hypertonia, disturbance of spatial location and other perception disorders. With respect to EDS-HT patients, they used more energy to stabilize postural sway during quiet upright stance than healthy subjects. The presence of vertical heterophoria was associated with a greater antero-posterior postural sway. Most of them had abnormal footprints (asymmetrical or hollow feet).
Conclusion
These data suggested that a dysfunction implicating somesthetic signals or central neurological integration could affect the balance control performance following the example of patients suffering from chronic low back pain. VH and hypermobility both or alone could be the sign or the trigger of this dysfunction. Postural instability could explained part of the symptoms of pain and fatigue in EDS-HT.
Disclosure:
R. Jaussaud,
None;
E. Vlamynck,
None;
R. Haidar,
None;
D. Lambert,
None;
V. Laurant-Noel,
None;
A. Servettaz,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ehlers-danlos-hypermobile-eds-ht-patients-and-postural-instability-another-clue-to-explain-pain-and-fatigue/