Johannessen Elise Christine, Reiten Helle Sundnes, Løvaas Helene, Maeland Silje, Juul-Kristensen Birgit
a Institute of Occupational Therapy, Physiotherapy and Radiography, Bergen University College , Bergen , Norway.
b Uni Research Health , Bergen , Norway.
Disabil Rehabil. 2016 Jul;38(14):1382-90. doi: 10.3109/09638288.2015.1102336. Epub 2016 Jan 29.
Purpose To investigate shoulder function, pain and Health-Related Quality of life (HRQoL) among adults with joint hypermobility syndrome/Ehlers-Danlos syndrome-hypermobility type (JHS/EDS-HT), compared with the general population (controls). Method In a cross-sectional study using postal survey, 110 patients diagnosed with JHS/EDS-HT and 140 gender- and age-matched healthy controls from Statistics Norway participated. Shoulder function, pain and HRQol were registered by Western Ontario Shoulder Instability Index (WOSI), Numerical Rating Scale (NRS), pain drawings, 36-item Short Form (SF-36). Results Eighty-one individuals responded, with response rate 34% (JHS/EDS-HT: 53%, controls: 21%). JHS/EDS-HT had lower shoulder function (WOSI total: 49.9 versus 83.3; p < 0.001), lower HRQol on SF-36 Physical Component Scale (PCS: 28.1 versus 49.9; p < 0.001), and higher pain intensity (NRS: 6.4 versus 2.7; p < 0.001) than controls. Neck and shoulder joints were rated as primary painful areas in both groups, with significantly higher frequency in JHS/EDS-HT (neck: 90% versus 27%; shoulder: 80% versus 37%). Further, JHS/EDS-HT most often reported generalized pain (96%). Conclusions Adults with JHS/EDS-HT have impaired shoulder function, increased pain intensity, as well as reduced physical HRQoL compared with controls. Although neck and shoulder were most frequently rated as painful, significantly more JHS/EDS-HT also reported generalized pain compared to controls. Implications for Rehabilitation Adults with JHS/EDS-HT have impaired shoulder function, and most often painful areas in the neck and shoulder joints, which need to be targeted in the treatment strategy. Compared with the general population adults with JHS/EDS-HT have reduced physical HRQoL, supporting a physical approach for this group. Adults with JHS/EDS-HT may present with both specific painful joints and generalized pain.
目的 调查关节过度活动综合征/埃勒斯-当洛综合征-过度活动型（JHS/EDS-HT）成人的肩部功能、疼痛及健康相关生活质量（HRQoL），并与普通人群（对照组）进行比较。方法 在一项采用邮寄调查的横断面研究中，110例被诊断为JHS/EDS-HT的患者和140例来自挪威统计局的年龄及性别匹配的健康对照参与研究。通过西安大略肩不稳定指数（WOSI）、数字评定量表（NRS）、疼痛图、36项简明健康状况调查量表（SF-36）记录肩部功能、疼痛及HRQoL。结果 81人回复，回复率为34%（JHS/EDS-HT组：53%，对照组：21%）。与对照组相比，JHS/EDS-HT组肩部功能更低（WOSI总分：49.9对83.3；p<0.001），SF-36身体成分量表上的HRQoL更低（PCS：28.1对49.9；p<0.001），疼痛强度更高（NRS：6.4对2.7；p<0.001）。两组均将颈部和肩关节评定为主要疼痛部位，JHS/EDS-HT组的频率显著更高（颈部：90%对27%；肩部：80%对37%）。此外，JHS/EDS-HT组最常报告全身性疼痛（96%）。结论 与对照组相比，JHS/EDS-HT成人的肩部功能受损、疼痛强度增加且身体HRQoL降低。尽管颈部和肩部最常被评定为疼痛部位，但与对照组相比，JHS/EDS-HT组报告全身性疼痛的人数也显著更多。康复意义 JHS/EDS-HT成人的肩部功能受损，颈部和肩关节最常出现疼痛部位，在治疗策略中需要针对这些部位。与普通人群相比，JHS/EDS-HT成人的身体HRQoL降低，支持对该组采用身体治疗方法。JHS/EDS-HT成人可能同时存在特定的疼痛关节和全身性疼痛。
