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Prevalence of Pain and Effect of Joint Strength on Perceived Physical Function in Pediatric Patients With
Nathaniel Garcia1, Ashley Lytch2, Emily Cramer2
1University of Kansas School of Medicine, Kansas City, KS.
Objective:
To identify how pediatric patients with hypermobile-type Ehlers-Danlos syndrome (hEDS) present to physical therapy (PT) and better understand their musculoskeletal dysfunction.
Design:
Patients were included in the study if they had a diagnosis of hEDS and at least 1 completed PT evaluation after diagnosis. A chart review was conducted to assess joint strength and pain characteristics at the initial PT assessment. Physical Function Mobility (PF-Mobility; 4 domains with 1-5 scale with higher score representative of better physical function) as part of the Patient-Reported Outcome Measurement Information System and pain intensity score (visual analog scale, 0-10 scale where a lower number indicates less pain) was completed by participants.
Setting:
Midwestern tertiary care center.
Participants:
Sixty-nine participants were included in the study with an average age of 16.4 years (SD 2.8) at the initial PT visit and 96% were female individuals.
Intervention:
Not applicable.
Main Outcome Measures:
Joint strength, pain intensity and location, and PF-Mobility.
Results:
The knee was the most reported location with pain (68%) followed by the shoulder (46%), hip (41%), and back (39%). Average pain intensity was 5.0 (SD 1.8), joint strength scores ranged from 8.2 (SD 0.9) to 9.9 (SD 0.4), and the PF-Mobility mean was 3.3 (SD 0.6). No correlation was noted between joint pain intensity and strength at the joint.
Conclusions:
Although the participants perceived poor mobility and significant pain, PT-assessed strength did not reveal significant muscle weakness. Additional work is needed to explore this discrepancy, including altered biomechanics, evaluation methods, and nonmusculoskeletal factors such as neuropathic and psychological components.
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