Hypermobile Ehlers-Danlos syndrome and rehabilitation: taking stock of evidence based medicine: a systematic review of the literature.

The final review included only one study, a cohort of 12 women. No randomised controlled trials were found for hEDS rehabilitation. The included cohort had no effective comparison, and its Newcastle-Ottawa score was 2 points for selection, 0 points for comparability, and 2 points for outcome, which the authors called poor quality. The cohort intervention combined strength training, body awareness exercises, core stability exercises, education, cognitive behavioural therapy, and home exercises, so the contribution of any single component cannot be separated. Five case reports were analysed only in brief and were not admitted to the final review. The cohort included only women, so it says nothing about men or other groups with hEDS. The review excluded papers on other hypermobile syndromes, such as joint hypermobility syndrome, so it may not cover all relevant rehabilitation evidence.

The authors declared no conflicts of interest.

Do not read the reported improvements as proof that rehabilitation works for hEDS. The only included study was a poor-quality cohort with no effective comparison, and the case reports were not admitted to the final review.