Angelo P. Amico, Ilaria Covelli, Marisa Megna and Pietro Fiore Pages 56 - 58 ( 3 )
The Ehlers-Danlos syndrome (EDS) is the most common hereditary disorder of connective tissue, with main manifestations in skin, joints and cardiovascular system. Hyperelasticity of skin, joint hypermobility and fragility of vessels and internal organs are responsible for severe physical disability and loss of autonomy in ADL (activities of daily life). Aim of the Study: To demonstrate efficacy in patients with hereditary disorders of connective tissue of dietary supplements based on collagen hydrolyzate in association with proprioceptive rehabilitation, by Prokin system, in improving postural stability, osteo-articular painful symptoms and bone density for the recovery of autonomy in ADL. Materials and Methods: A patient of 53 years with genetic diagnosis of Ehlers-Danlos Syndrome type Classic (mutation COL1A1) who had several sprains in the lower limbs, complained pain syndrome in the left ankle and right knee, associated with postural instability. We assessed him by WOMAC, VAS pain scale and Tinetti Balance Scale; by proprioceptive multiaxial test of Prokin; and by bone densitometry. Then he underwent 2 cycles of 10 sessions of proprioceptive rehabilitation with Prokin. In addition, he was prescribed therapy for one month with the PROTOCOL dietary supplement of collagen hydrolyzate 1 flc / day. At the end of the 2 cycles, all the previous tests and evaluations were repeated. Results: The comparison between the scores at T0 (one day before treatment) and T1 (one day after treatment) showed a reduction of pain and stiffness and an improvement of physical function (WOMAC scale from 26/96 to 0/96, VAS of pain from "intense" to "no pain". Postural instability measured by Tinetti balance scale reduced at time t1 compared to t0; This finding has been confirmed by proprioceptive test of prokin, with a reduction in the percentage of error (ATE) from 34% to 20%, and the index of instability from 1.2 to 0.80. After a month of therapy PROTOCOL, dietary supplement of hydrolyzed collagen 1 flc / day, a reduction in the T-score at DEXA from -2.6 to -1.6 was documented. Also at clinical examination at T1, we found reduced postural instability in monopodalic standing, and less critical postural changes, with significant improvement of functional independence and quality of life of the patient. Conclusions: The preliminary results show how the integration of a proprioceptive rehabilitation, such as Prokin exercises, with dietary supplementation of collagen can lead to a reduction (in this case a resolution) in pain and a functional improvement and recovery of autonomy in ADL.
Collagen supplements, Ehlers-Danlos syndrome, hereditary disorders, Prokin, rehabilitation, Tinetti Balance Scale.
Department of Physical Medicine and Rehabilitation, Policlinico of Bari, University of Bari, Bari, Italy.