Abstract：
To investigate the effectiveness of two home-based exercise programs for treating multidirectional shoulder instability (MDI) in patients diagnosed with Hypermobile Ehlers-Danlos syndrome (hEDS) or Hypermobility Spectrum Disorders (HSD).
Twenty-one hEDS/HSD patients with MDI were recruited from the Center for Medical Genetics of the Ghent University Hospital. Patients were randomly assigned to either the experimental or the control group. Both groups received a 6-month home-based exercise program. The primary outcome measure was the Western Ontario Shoulder Index (WOSI). Secondary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH), Tampa Scale for Kinesiophobia (TSK), Patient-Specific Functional Scale (PSFS), Global Rating of Change (GROC), and pain pressure thresholds. Outcomes were assessed at baseline, after 6 weeks, 12 weeks, and 24 weeks.
Significant main effects for time were observed for all questionnaires, except for the TSK (p = 0.12). Patients improved 240 and 325 points on the WOSI after 12 (p = 0.02) and 24 weeks (p = 0.001), respectively. Additionally, patients improved 8.6 points on the DASH (p = 0.002), 4.3 points on the PSFS (p = 0.01), and 1.02 points on the GROC (p = 0.001) after 24 weeks.
No significant differences were found between group A and B. Both home-based exercise programs led to significant improvements in shoulder function. IMPLICATIONS FOR REHABILITATIONHome-based exercise therapy may be effective for treating MDI in the hEDS/HSD population.Home-based training is beneficial for improving shoulder function, but a multidisciplinary, supervised approach might be more effective for altering kinesiophobia in this patient population.
Twenty-one hEDS/HSD patients with MDI were recruited from the Center for Medical Genetics of the Ghent University Hospital. Patients were randomly assigned to either the experimental or the control group. Both groups received a 6-month home-based exercise program. The primary outcome measure was the Western Ontario Shoulder Index (WOSI). Secondary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH), Tampa Scale for Kinesiophobia (TSK), Patient-Specific Functional Scale (PSFS), Global Rating of Change (GROC), and pain pressure thresholds. Outcomes were assessed at baseline, after 6 weeks, 12 weeks, and 24 weeks.
Significant main effects for time were observed for all questionnaires, except for the TSK (p = 0.12). Patients improved 240 and 325 points on the WOSI after 12 (p = 0.02) and 24 weeks (p = 0.001), respectively. Additionally, patients improved 8.6 points on the DASH (p = 0.002), 4.3 points on the PSFS (p = 0.01), and 1.02 points on the GROC (p = 0.001) after 24 weeks.
No significant differences were found between group A and B. Both home-based exercise programs led to significant improvements in shoulder function. IMPLICATIONS FOR REHABILITATIONHome-based exercise therapy may be effective for treating MDI in the hEDS/HSD population.Home-based training is beneficial for improving shoulder function, but a multidisciplinary, supervised approach might be more effective for altering kinesiophobia in this patient population.
摘要：
UNASSIGNED：本研究旨在研究两种基于家庭的运动计划治疗诊断为HypermobileEhlers-Danlos综合征（hEDS）或高移动频谱障碍（HSD）的患者多向肩关节不稳定（MDI）的有效性。
未经证实：21名患有MDI的hEDS/HSD患者从根特大学医院医学遗传学中心招募。患者被随机分配到实验组或对照组。两组都接受了为期6个月的家庭锻炼计划。主要结果指标是西安大略肩指数（WOSI）。次要结果包括手臂残疾，肩和手(DASH)运动恐惧症的坦帕量表（TSK），患者特定功能量表（PSFS），全球变化评级(GROC)，和疼痛压力阈值。结果在基线评估，6周后,12周,和24周。
UNASSIGNED：在所有问卷中都观察到了时间的显着主要影响，除了TSK(p=0.12)。在12周（p=0.02）和24周（p=0.001）后，患者在WOSI上提高了240和325分，分别。此外,患者在DASH上提高了8.6分(p=0.002)，PSFS上的4.3点(p=0.01)，24周后GROC的1.02点（p=0.001）。
UNASSIGNED：在A组和B组之间没有发现显着差异。两种以家庭为基础的锻炼计划均导致肩部功能的显着改善。对康复的影响基于家庭的运动疗法可能对治疗hEDS/HSD人群中的MDI有效。居家训练有利于改善肩关节功能,而是多学科的，监督方法可能更有效地改变该患者人群的运动恐惧症。
未经证实：21名患有MDI的hEDS/HSD患者从根特大学医院医学遗传学中心招募。患者被随机分配到实验组或对照组。两组都接受了为期6个月的家庭锻炼计划。主要结果指标是西安大略肩指数（WOSI）。次要结果包括手臂残疾，肩和手(DASH)运动恐惧症的坦帕量表（TSK），患者特定功能量表（PSFS），全球变化评级(GROC)，和疼痛压力阈值。结果在基线评估，6周后,12周,和24周。
UNASSIGNED：在所有问卷中都观察到了时间的显着主要影响，除了TSK(p=0.12)。在12周（p=0.02）和24周（p=0.001）后，患者在WOSI上提高了240和325分，分别。此外,患者在DASH上提高了8.6分(p=0.002)，PSFS上的4.3点(p=0.01)，24周后GROC的1.02点（p=0.001）。
UNASSIGNED：在A组和B组之间没有发现显着差异。两种以家庭为基础的锻炼计划均导致肩部功能的显着改善。对康复的影响基于家庭的运动疗法可能对治疗hEDS/HSD人群中的MDI有效。居家训练有利于改善肩关节功能,而是多学科的，监督方法可能更有效地改变该患者人群的运动恐惧症。
