Effects of compression garments on balance in hypermobile Ehlers-Danlos syndrome: a randomized controlled trial

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

IMPLICATIONS FOR REHABILITATION

• Compression garments immediately improve balance in people with hypermobile Ehlers-Danlos Syndrome (hEDS)

• Compression garments combined with regular physiotherapy improve balance in people with hEDS after 4 weeks of treatment

• Compression garments could compensate for proprioceptive impairment in hEDS

Keywords:

• Joint hypermobility
• orthoses
• physiotherapy
• postural sway
• proprioception
• pain
• force platform

Acknowledgements

We would like to thank patients with hEDS who participated in this study; Lyvia Sala and Martin Peschanski, physiotherapists, and Camille Jarnet, nurse, for their great contribution to the acquisition of the data. We thank Lara Jorge for her contributions to data analysis, interpretation, writing, editing, and revision of the manuscript. We thank Johanna Robertson for language editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the UNSED patient organisation and sponsored by La Fondation Garches (Garches Foundation).