Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can ev... more Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can evolve in childhood. It is unclear to what extent children with HCTD experience burden of disease. This study aims to quantify fatigue, pain, disability and general health with standardized validated questionnaires. Methods. This observational, multicenter study included 107 children, aged 4–18 years, with Marfan syndrome (MFS), 58%; Loeys-Dietz syndrome (LDS), 7%; Ehlers-Danlos syndromes (EDS), 8%; and hypermobile Ehlers-Danlos syndrome (hEDS), 27%. The assessments included PROMIS Fatigue Parent–Proxy and Pediatric self-report, pain and general health Visual-Analogue-Scales (VAS) and a Childhood Health Assessment Questionnaire (CHAQ). Results. Compared to normative data, the total HCTD-group showed significantly higher parent-rated fatigue T-scores (M = 53 (SD = 12), p = 0.004, d = 0.3), pain VAS scores (M = 2.8 (SD = 3.1), p < 0.001, d = 1.27), general health VAS scores (M = 2.5 (SD =...
CONCLUSION Subjects : Twenty-three female EDS-HT patients (age : 44.3±12.3; Beighton Scale 6.3±1.... more CONCLUSION Subjects : Twenty-three female EDS-HT patients (age : 44.3±12.3; Beighton Scale 6.3±1.9) and 23 age matched healthy controls (age : 44.7±12.3; Beighton Scale 2.8±1.8) were recruited. Materials : The ‘Foot Posture Index 6’ (FPI-6) was conducted regarding foot alignment. This test contains 6 items which are scored from 0 (neutral) to -2 (supination) and to +2 (pronation). A sum score will be reported. The ‘Lunge Test’ was carried out for determining ankle dorsi flexion range of motion in a weight-bearing position. For both test, mean side-to-side differences (expressing symmetry) between both feet are expressed as the ‘foot symmetry index’ (%FSI).
Disclaimer/Complaints regulations If you believe that digital publication of certain material inf... more Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please contact the library: http://www.hva.nl/bibliotheek/contact/contactformulier/contact.html, or send a letter to: University Library (Library of the University of Amsterdam and Amsterdam University of Applied Sciences), Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.
Reduced maximal muscle strength and strength endurance have been found in patients with hypermobi... more Reduced maximal muscle strength and strength endurance have been found in patients with hypermobile Ehlers‐Danlos syndrome/hypermobility spectrum disorder (hEDS/HSD) and are recognized as common associated features of the disorder. However, the extent to which these parameters change over time is currently not documented. Therefore, the purpose of this 8‐year follow‐up study was to investigate this evolution.
OBJECTIVE Ankle-foot problems have a considerable impact on daily functioning in patients with hy... more OBJECTIVE Ankle-foot problems have a considerable impact on daily functioning in patients with hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorder (hEDS/HSD). Therefore, the objective of this study is to identify alterations in multi-segment ankle and foot kinematics during gait and assessing foot function and pain in these patients. METHODS Twenty-three women with hEDS/HSD and 23 healthy controls participated in this three-dimensional (3D) gait analysis. Multi-segment ankle and foot kinematics were collected using the Ghent Foot Model (GFM) and analyzed with Statistical Parametric Mapping (SPM). Foot function and pain were assessed using Visual Analogue Scale (VAS)-scores, the Margolis Pain Diagram, and the Foot Function Index (FFI). RESULTS Levels of pain and foot dysfunction were significantly higher in subjects with hEDS/HSD (p<0.001). Kinematic curve analyses provide evidence for a hypermobile first ray, represented by a significantly increased eversion position of the medial forefoot during stance phase (p<0.001) in subjects with hEDS/HSD compared to controls. In addition, significantly more dorsiflexion was found in the medial and lateral forefoot and the rearfoot (p<0.001). At the midfoot an increased plantar flexion (p<0.001) and at the level of the hallux a decreased dorsiflexion (p=0.037) and increased inversion (p<0.001) and abduction (p=0.016) were found in subjects with hEDS/HSD. CONCLUSION This study is the first to apply a multi-segment foot model during gait in hEDS/HSD, which confirms the characteristic hypermobility throughout the foot, especially the hypermobile first ray.
A synoptic description of the autonomic symptoms profile (ASP) of patients with COPD is not avail... more A synoptic description of the autonomic symptoms profile (ASP) of patients with COPD is not available. Therefore, we aimed to provide an overview of autonomic symptoms and its associates in COPD. We evaluated 89 subjects with COPD (65 ± 7.3 years; 66 males; GOLD II-IV) with an equal number of age- and sex-matched control subjects by means of the composite autonomic symptom score (COMPASS 31) questionnaire, which assesses autonomic symptoms across six domains (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, urinary and pupillomotor). Lung function, medication use and health status variables (quality of life: physical/mental component summary [PCS/MCS], fatigue, anxiety, depression and dyspnea levels) were also assessed. Compared to controls, all subjects with COPD reported significantly higher orthostatic intolerance, secretomotor and total autonomic symptom scores (p &amp;amp;amp;amp;lt; .05). Additionally, subjects with moderate COPD also reported significantly higher scores for vasomotor, gastrointestinal, urinary and pupillomotor symptoms compared to controls (p &amp;amp;amp;amp;lt; .05). Nevertheless, these symptoms were comparable between the moderate and severe COPD subgroups (p &amp;amp;amp;amp;gt; .05). The COPD subjects had poorer health status compared to controls as exhibited by significantly higher scores for depression, anxiety, fatigue and dyspnea, and lower scores values for PCS and MCS scores (p &amp;amp;amp;amp;lt; .05). These health status variables were mildly associated with autonomic symptoms (0.214 ≤ r ≥ 0.421; p &amp;amp;amp;amp;lt; .05), but not with demographic and lung function (p &amp;amp;amp;amp;gt; .05). The MCS was the only significant predictor of total autonomic symptoms score in COPD (p = 0.001; β = -0.430). Autonomic symptoms are present in all domains of the COMPASS-31 in COPD, irrespective of disease severity and demographic variables. Autonomic symptoms in COPD were mainly influenced by poor mental health.
The consequences of the Ehlers-Danlos Syndrome hypermobility type (EDS-HT) affect many aspects of... more The consequences of the Ehlers-Danlos Syndrome hypermobility type (EDS-HT) affect many aspects of daily life. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Living with limitations&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is a central theme in the life of patients affected by this heritable disorder of connective tissue. The aim of the present study was to explore the lived experiences of women with EDS-HT concerning diagnosis, influence on daily life and becoming and being a mother. A phenomenological-hermeneutical study, using in-depth interviews. Patients were selected by a purposive sampling strategy. This study shows that the EDS-HT syndrome affects daily life. Ten woman between 31 and 65 years were interviewed. They have between 2 and 5 children. The data analysis results in six themes. (1) Getting a diagnosis is a relief and supports the choice to become a mother; (2) EDS-HT causes emotional distress, imposes a physical burden and has a major impact on social behavior; (3) EDS-HT demands a restructuring of everyday activities; (4) Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s and mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; expectations do not correspond; (5) Having a supportive social and physical environment is of major importance; (6) The presence of the child reduces the feeling of illness of the mother. The diagnosis of EDS-HT is a catalysing factor in the choice of whether or not to become a mother. EDS-HT has a huge impact on bodily functions, which in turn influences activities and participation. This study gives insight in the activities of daily life of persons with EDS-HT. Health care professionals can be of great importance to help patients in (re)organizing their lives according to the available energy and in supporting their choices. They can help defining goals and setting priorities in daily life.
Archives of physical medicine and rehabilitation, Dec 11, 2016
To (1) establish the association of the most common reported symptoms on disability; and (2) stud... more To (1) establish the association of the most common reported symptoms on disability; and (2) study the effectiveness of treatment on disability in patients with Ehlers-Danlos syndrome-hypermobility type (EDS-HT)/hypermobility syndrome (HMS). An electronic search (Medical Subject Headings and free-text terms) was conducted in bibliographic databases CENTRAL/MEDLINE. Comparative, cross-sectional, longitudinal cohort studies and (randomized) controlled trials including patients with HMS/EDS-HT aged ≥17 years were considered for inclusion. A class of symptoms was included when 5 publications were available. In regards to treatment (physical, cognitive interventions), only (randomized) controlled trials were considered. Surgical and medicinal interventions were excluded. Bias was assessed according to the methodological scoring tools of the Cochrane collaboration. Z-score transformations were applied to classify the extent of disability in comparison with healthy controls and to ensure c...
The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized ... more The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness, potentially leading to activity limitations. In EDS-HT, a direct relationship between muscle strength, proprioception and activity limitations has never been studied. The objective of the study was to establish the association between muscle strength and activity limitations and the impact of proprioception on this association in EDS-HT patients. Twenty-four EDS-HT patients were compared with 24 controls. Activity limitations were quantified by Health Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise test (30CRT). Muscle strength was quantified by handheld dynamometry. Proprioception was quantified by movement detection paradigm. In analyses, the association between muscle strength and activity limitations was controlled for proprioception and confounders. Muscle strength was associated with 30CRT (r = 0.67,...
To investigate whether orthostatic intolerance (OI) is a significant predictor for fatigue in Ehl... more To investigate whether orthostatic intolerance (OI) is a significant predictor for fatigue in Ehlers-Danlos Syndrome, hypermobility type (EDS-HT). Eighty patients with EDS-HT and 52 controls participated in the first part of the study, which consisted of questionnaires. Fatigue was evaluated using the Checklist Individual Strength (CIS). As possible fatigue determinants OI [Autonomic Symptom Profile (ASP)], habitual physical activity (Baecke), affective distress [Hospital Anxiety and Depression Scale (HADS)], pain (SF36), medication use and generalized hypermobility (5-point score of Grahame and Hakim regarding generalized joint hypermobility) were studied. Next, a 20 min head-up tilt (70°) was performed in a subsample of 39 patients and 35 controls, while beat-to-beat heart rate and blood pressure were monitored (Holter, Finometer Pro). Before and after tilt, fatigue severity was assessed using a numeric rating scale. Patients scored significantly higher on the CIS [total score: ED...
Background Ehlers Danlos Syndrome, hypermobility type(EDS-HT) is characterized by overall connect... more Background Ehlers Danlos Syndrome, hypermobility type(EDS-HT) is characterized by overall connective tissue laxity and associated with chronic pain, fatigue and subsequent disability. Literature reports that EDS-HT also has profound effects on the level of psychological well being. The incidence of anxiety related disorders is more prevalent in individuals with EDS-HT in comparison to other populations. In addition, maladaptive coping have also been reported. Still in EDS-HT no evidence is available regarding the consequences of psychological comorbidity on activity impairments and it remains unclear how this is influenced by the way patients cope with their disability. Objectives To establish the association between pain and activity impairments controlled for psychological comorbidity and coping in patients with EDS-HT. Methods 25 patients with EDS-HT according to the Villefranche criteria were included and compared to 25 age and gender matched controls. Activity impairments, on c...
cates that the medial support was effective at reducing rearfoot eversion, as was intended by the... more cates that the medial support was effective at reducing rearfoot eversion, as was intended by the shoe manufacturer but that further footwear technologies must be developed in order to guide calcaneal adduction. The present study found a correlation between rearfoot adduction and tibial rotation with similar strength as a previously published study on the barefoot running (Fischer et al., 2017). This indicates the relevance of rearfoot adduction control. The missing influence of footwear on tibial rotation could be explained by the contradictory results found for the effect of footwear on rearfoot eversion compared to rearfoot adduction. On average, the contrary effects would indicate no effect on tibial rotation. Future motion control footwear design, for runners suffering from problems related to tibial rotation, should take rearfoot adduction into consideration. Disclosure statement
Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can ev... more Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can evolve in childhood. It is unclear to what extent children with HCTD experience burden of disease. This study aims to quantify fatigue, pain, disability and general health with standardized validated questionnaires. Methods. This observational, multicenter study included 107 children, aged 4–18 years, with Marfan syndrome (MFS), 58%; Loeys-Dietz syndrome (LDS), 7%; Ehlers-Danlos syndromes (EDS), 8%; and hypermobile Ehlers-Danlos syndrome (hEDS), 27%. The assessments included PROMIS Fatigue Parent–Proxy and Pediatric self-report, pain and general health Visual-Analogue-Scales (VAS) and a Childhood Health Assessment Questionnaire (CHAQ). Results. Compared to normative data, the total HCTD-group showed significantly higher parent-rated fatigue T-scores (M = 53 (SD = 12), p = 0.004, d = 0.3), pain VAS scores (M = 2.8 (SD = 3.1), p < 0.001, d = 1.27), general health VAS scores (M = 2.5 (SD =...
CONCLUSION Subjects : Twenty-three female EDS-HT patients (age : 44.3±12.3; Beighton Scale 6.3±1.... more CONCLUSION Subjects : Twenty-three female EDS-HT patients (age : 44.3±12.3; Beighton Scale 6.3±1.9) and 23 age matched healthy controls (age : 44.7±12.3; Beighton Scale 2.8±1.8) were recruited. Materials : The ‘Foot Posture Index 6’ (FPI-6) was conducted regarding foot alignment. This test contains 6 items which are scored from 0 (neutral) to -2 (supination) and to +2 (pronation). A sum score will be reported. The ‘Lunge Test’ was carried out for determining ankle dorsi flexion range of motion in a weight-bearing position. For both test, mean side-to-side differences (expressing symmetry) between both feet are expressed as the ‘foot symmetry index’ (%FSI).
Disclaimer/Complaints regulations If you believe that digital publication of certain material inf... more Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please contact the library: http://www.hva.nl/bibliotheek/contact/contactformulier/contact.html, or send a letter to: University Library (Library of the University of Amsterdam and Amsterdam University of Applied Sciences), Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.
Reduced maximal muscle strength and strength endurance have been found in patients with hypermobi... more Reduced maximal muscle strength and strength endurance have been found in patients with hypermobile Ehlers‐Danlos syndrome/hypermobility spectrum disorder (hEDS/HSD) and are recognized as common associated features of the disorder. However, the extent to which these parameters change over time is currently not documented. Therefore, the purpose of this 8‐year follow‐up study was to investigate this evolution.
OBJECTIVE Ankle-foot problems have a considerable impact on daily functioning in patients with hy... more OBJECTIVE Ankle-foot problems have a considerable impact on daily functioning in patients with hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorder (hEDS/HSD). Therefore, the objective of this study is to identify alterations in multi-segment ankle and foot kinematics during gait and assessing foot function and pain in these patients. METHODS Twenty-three women with hEDS/HSD and 23 healthy controls participated in this three-dimensional (3D) gait analysis. Multi-segment ankle and foot kinematics were collected using the Ghent Foot Model (GFM) and analyzed with Statistical Parametric Mapping (SPM). Foot function and pain were assessed using Visual Analogue Scale (VAS)-scores, the Margolis Pain Diagram, and the Foot Function Index (FFI). RESULTS Levels of pain and foot dysfunction were significantly higher in subjects with hEDS/HSD (p<0.001). Kinematic curve analyses provide evidence for a hypermobile first ray, represented by a significantly increased eversion position of the medial forefoot during stance phase (p<0.001) in subjects with hEDS/HSD compared to controls. In addition, significantly more dorsiflexion was found in the medial and lateral forefoot and the rearfoot (p<0.001). At the midfoot an increased plantar flexion (p<0.001) and at the level of the hallux a decreased dorsiflexion (p=0.037) and increased inversion (p<0.001) and abduction (p=0.016) were found in subjects with hEDS/HSD. CONCLUSION This study is the first to apply a multi-segment foot model during gait in hEDS/HSD, which confirms the characteristic hypermobility throughout the foot, especially the hypermobile first ray.
A synoptic description of the autonomic symptoms profile (ASP) of patients with COPD is not avail... more A synoptic description of the autonomic symptoms profile (ASP) of patients with COPD is not available. Therefore, we aimed to provide an overview of autonomic symptoms and its associates in COPD. We evaluated 89 subjects with COPD (65 ± 7.3 years; 66 males; GOLD II-IV) with an equal number of age- and sex-matched control subjects by means of the composite autonomic symptom score (COMPASS 31) questionnaire, which assesses autonomic symptoms across six domains (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, urinary and pupillomotor). Lung function, medication use and health status variables (quality of life: physical/mental component summary [PCS/MCS], fatigue, anxiety, depression and dyspnea levels) were also assessed. Compared to controls, all subjects with COPD reported significantly higher orthostatic intolerance, secretomotor and total autonomic symptom scores (p &amp;amp;amp;amp;lt; .05). Additionally, subjects with moderate COPD also reported significantly higher scores for vasomotor, gastrointestinal, urinary and pupillomotor symptoms compared to controls (p &amp;amp;amp;amp;lt; .05). Nevertheless, these symptoms were comparable between the moderate and severe COPD subgroups (p &amp;amp;amp;amp;gt; .05). The COPD subjects had poorer health status compared to controls as exhibited by significantly higher scores for depression, anxiety, fatigue and dyspnea, and lower scores values for PCS and MCS scores (p &amp;amp;amp;amp;lt; .05). These health status variables were mildly associated with autonomic symptoms (0.214 ≤ r ≥ 0.421; p &amp;amp;amp;amp;lt; .05), but not with demographic and lung function (p &amp;amp;amp;amp;gt; .05). The MCS was the only significant predictor of total autonomic symptoms score in COPD (p = 0.001; β = -0.430). Autonomic symptoms are present in all domains of the COMPASS-31 in COPD, irrespective of disease severity and demographic variables. Autonomic symptoms in COPD were mainly influenced by poor mental health.
The consequences of the Ehlers-Danlos Syndrome hypermobility type (EDS-HT) affect many aspects of... more The consequences of the Ehlers-Danlos Syndrome hypermobility type (EDS-HT) affect many aspects of daily life. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Living with limitations&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is a central theme in the life of patients affected by this heritable disorder of connective tissue. The aim of the present study was to explore the lived experiences of women with EDS-HT concerning diagnosis, influence on daily life and becoming and being a mother. A phenomenological-hermeneutical study, using in-depth interviews. Patients were selected by a purposive sampling strategy. This study shows that the EDS-HT syndrome affects daily life. Ten woman between 31 and 65 years were interviewed. They have between 2 and 5 children. The data analysis results in six themes. (1) Getting a diagnosis is a relief and supports the choice to become a mother; (2) EDS-HT causes emotional distress, imposes a physical burden and has a major impact on social behavior; (3) EDS-HT demands a restructuring of everyday activities; (4) Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s and mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; expectations do not correspond; (5) Having a supportive social and physical environment is of major importance; (6) The presence of the child reduces the feeling of illness of the mother. The diagnosis of EDS-HT is a catalysing factor in the choice of whether or not to become a mother. EDS-HT has a huge impact on bodily functions, which in turn influences activities and participation. This study gives insight in the activities of daily life of persons with EDS-HT. Health care professionals can be of great importance to help patients in (re)organizing their lives according to the available energy and in supporting their choices. They can help defining goals and setting priorities in daily life.
Archives of physical medicine and rehabilitation, Dec 11, 2016
To (1) establish the association of the most common reported symptoms on disability; and (2) stud... more To (1) establish the association of the most common reported symptoms on disability; and (2) study the effectiveness of treatment on disability in patients with Ehlers-Danlos syndrome-hypermobility type (EDS-HT)/hypermobility syndrome (HMS). An electronic search (Medical Subject Headings and free-text terms) was conducted in bibliographic databases CENTRAL/MEDLINE. Comparative, cross-sectional, longitudinal cohort studies and (randomized) controlled trials including patients with HMS/EDS-HT aged ≥17 years were considered for inclusion. A class of symptoms was included when 5 publications were available. In regards to treatment (physical, cognitive interventions), only (randomized) controlled trials were considered. Surgical and medicinal interventions were excluded. Bias was assessed according to the methodological scoring tools of the Cochrane collaboration. Z-score transformations were applied to classify the extent of disability in comparison with healthy controls and to ensure c...
The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized ... more The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness, potentially leading to activity limitations. In EDS-HT, a direct relationship between muscle strength, proprioception and activity limitations has never been studied. The objective of the study was to establish the association between muscle strength and activity limitations and the impact of proprioception on this association in EDS-HT patients. Twenty-four EDS-HT patients were compared with 24 controls. Activity limitations were quantified by Health Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise test (30CRT). Muscle strength was quantified by handheld dynamometry. Proprioception was quantified by movement detection paradigm. In analyses, the association between muscle strength and activity limitations was controlled for proprioception and confounders. Muscle strength was associated with 30CRT (r = 0.67,...
To investigate whether orthostatic intolerance (OI) is a significant predictor for fatigue in Ehl... more To investigate whether orthostatic intolerance (OI) is a significant predictor for fatigue in Ehlers-Danlos Syndrome, hypermobility type (EDS-HT). Eighty patients with EDS-HT and 52 controls participated in the first part of the study, which consisted of questionnaires. Fatigue was evaluated using the Checklist Individual Strength (CIS). As possible fatigue determinants OI [Autonomic Symptom Profile (ASP)], habitual physical activity (Baecke), affective distress [Hospital Anxiety and Depression Scale (HADS)], pain (SF36), medication use and generalized hypermobility (5-point score of Grahame and Hakim regarding generalized joint hypermobility) were studied. Next, a 20 min head-up tilt (70°) was performed in a subsample of 39 patients and 35 controls, while beat-to-beat heart rate and blood pressure were monitored (Holter, Finometer Pro). Before and after tilt, fatigue severity was assessed using a numeric rating scale. Patients scored significantly higher on the CIS [total score: ED...
Background Ehlers Danlos Syndrome, hypermobility type(EDS-HT) is characterized by overall connect... more Background Ehlers Danlos Syndrome, hypermobility type(EDS-HT) is characterized by overall connective tissue laxity and associated with chronic pain, fatigue and subsequent disability. Literature reports that EDS-HT also has profound effects on the level of psychological well being. The incidence of anxiety related disorders is more prevalent in individuals with EDS-HT in comparison to other populations. In addition, maladaptive coping have also been reported. Still in EDS-HT no evidence is available regarding the consequences of psychological comorbidity on activity impairments and it remains unclear how this is influenced by the way patients cope with their disability. Objectives To establish the association between pain and activity impairments controlled for psychological comorbidity and coping in patients with EDS-HT. Methods 25 patients with EDS-HT according to the Villefranche criteria were included and compared to 25 age and gender matched controls. Activity impairments, on c...
cates that the medial support was effective at reducing rearfoot eversion, as was intended by the... more cates that the medial support was effective at reducing rearfoot eversion, as was intended by the shoe manufacturer but that further footwear technologies must be developed in order to guide calcaneal adduction. The present study found a correlation between rearfoot adduction and tibial rotation with similar strength as a previously published study on the barefoot running (Fischer et al., 2017). This indicates the relevance of rearfoot adduction control. The missing influence of footwear on tibial rotation could be explained by the contradictory results found for the effect of footwear on rearfoot eversion compared to rearfoot adduction. On average, the contrary effects would indicate no effect on tibial rotation. Future motion control footwear design, for runners suffering from problems related to tibial rotation, should take rearfoot adduction into consideration. Disclosure statement
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