PDF(Pubmed)
Abstract：
Hypermobility spectrum disorders (HSD) affect individuals across physical, psychological and social domains, making assessment and management difficult. Management for this condition primarily focuses on addressing the musculoskeletal complaints using physiotherapy rather than the additional manifestations such as fatigue, anxiety and depression. This systematic review aims to identify psychological interventions and assess whether they improve the lived experiences of individuals with HSD. It also aims to assess which psychological interventions were most effective, which symptoms were most effectively managed by a psychological intervention, and whether there were differences between children and adults. Studies were included if they were a randomised controlled trial or pre/post-test design, a sample of any age and clinical diagnosis of HSD (including Ehlers-Danlos syndrome), used a psychological intervention and assessed the effect of the intervention on lived experiences using appropriate outcome measures. Risk of bias was assessed using the Mixed Methods Appraisal Tool. The results were narratively synthesised. Six studies were included in the review, one isolated psychological intervention and five incorporated a psychological intervention within a multidisciplinary programme. The interventions predominantly aimed to reduce pain including intensity, interference, pain-related fear and catastrophising, with anxiety and depression, affect, daily living, fatigue also being evaluated. The most beneficial psychological interventions were those delivered alongside physiotherapy in an outpatient or community setting, improving both the physical and psychological aspects of pain, subsequently improving quality of life. However, there lacks randomised controlled trials with larger samples to definitively confirm the significant findings discussed in this review.
摘要：
高移动性频谱障碍（HSD）影响个人的身体，心理和社会领域，使评估和管理变得困难。这种情况的管理主要集中在使用物理疗法解决肌肉骨骼投诉，而不是其他表现，如疲劳，焦虑和抑郁。本系统综述旨在确定心理干预措施，并评估它们是否改善了HSD患者的生活体验。它还旨在评估哪些心理干预措施最有效，通过心理干预最有效地控制了哪些症状，以及儿童和成人之间是否存在差异。如果研究是随机对照试验或试验前/试验后设计，任何年龄和临床诊断的HSD（包括Ehlers-Danlos综合征）的样本，使用心理干预，并使用适当的结局指标评估干预对生活经历的影响。使用混合方法评估工具评估偏倚风险。对结果进行了叙述综合。六项研究被纳入审查，一个孤立的心理干预和五个在多学科计划中纳入心理干预。干预措施主要旨在减轻疼痛，包括强度，干扰,与疼痛相关的恐惧和灾难，焦虑和抑郁，影响，日常生活,疲劳也在评估中。最有益的心理干预措施是在门诊或社区环境中与物理治疗一起提供的干预措施，改善疼痛的身体和心理方面，从而提高生活质量。然而,缺乏更大样本的随机对照试验来明确证实本综述中讨论的重要发现.
