Vibroacoustic Therapy for Ehlers-Danlos Syndrome: A Case Study

Picard LM, Bartel LR, Gordon AS, Denise Paneduro, Sally Chung and Pink LR

Music and Health Research Collaboratory, University of Toronto, USA
Wasser Pain Management Centre, Mount Sinai Hospital, Toronto Ontario, USA

^*Correspondance to: Picard LM 

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Abstract:

Background: Widespread pain and tenderness are prominent features of Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT). Chronic pain in this condition may be perpetuated by central nervous system sensitization and is refractory to treatment. Vibroacoustic therapy has the potential to modulate pain responses via somatosensory input.Objective: To examine the effects of a short course of self-administered, home-based vibroacoustic chair therapy as add-on treatment in EDS.
Methods: A patient with painful EDS was supplied with a vibroacoustic chair. The patient used the chair up to seven days per week twice per day for 53 out of a possible 58 sessions over 29 consecutive treatment days (approximately 4 weeks), followed by a two week “washout” period. Responses were assessed using the Brief Pain Inventory, Short Form (BPI-SF) and the Sleep Quality Numerical Rating Scale (SQNRS) administered at study initiation, and at the end of weeks 2, 4 and 6. A patient global impression of change (GIC-P) was obtained at the conclusion of active treatment (week 4). Thirty minute semi-structured interviews were carried out at the end of week 4 and week 6. The change from baseline in the BPI subscales, the Pain Severity Score (PSS) and the Pain Interference Score (PIS), from baseline to end of the active treatment period and patient global impression of change were the primary end points. Changes in the SQNRS over the course of the study and the changes in BPI subscales and from time of treatment termination until the final assessment were the secondary endpoints.Results: The PSS was 7.75 at baseline and unchanged at termination of treatment. The PIS improved by 2.43 points from baseline (8.86) to termination of active treatment (6.43). Patient Global Impression of Change was “slightly better” following treatment. The patient experienced a mostly positive stimulation of bowel function, relaxation and/or lessening of muscle tension, and an improvement in energy levels. Bothersome tingling sensations were experienced especially close to the time of initiation for a brief period but there were no serious adverse effects. During the washout period, the PSS increased slightly by 0.25 points between the termination of therapy (7.75) and final follow-up (8.0). The PIS changed 1.14 points, from 6.43 at termination of therapy to 7.57 at final assessment. Sleep quality also worsened during the washout period with an increase in the SQNRS scale from 8 to 9 although it did not change from baseline during the active treatment period. There was some overall deterioration in symptom control in the two weeks after treatment termination.Conclusions: This N of 1 study suggests modest symptom improvement from vibroacoustic therapy in EDS-HT. There was an unexpected effect of bowel stimulation. Larger controlled studies are needed to confirm and extend these findings.

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Cite the Article:

Picard LM, Bartel LR, Gordon AS, Paneduro D, Chung S, Pink LR. Vibroacoustic Therapy for Ehlers- Danlos Syndrome: A Case Study. Ann Clin Case Rep. 2018; 3: 1504.