A novel method of assessing balance and postural sway in patients with hypermobile Ehlers-Danlos syndrome.

Patients with hypermobile Ehlers-Danlos syndrome (hEDS) frequently suffer from poor balance and proprioception and are at an increased risk for falls. Here we present a means of assessing a variety of balance and postural conditions in a fast and non-invasive manner. The equipment required is commercially available and requires limited personnel. Patients can be repeatedly tested to determine balance and postural differences as a result of disease progression and aging, or a reversal following balance/exercise interventions.

High-intensity exercise improves pulmonary function and exercise tolerance in a patient with TSC-LAM.

INTRODUCTION: While exercise has been shown to improve respiratory symptoms, exercise tolerance, and bone mineral density in many populations, no supervised exercise training interventions have been undertaken in patients with lymphangioleiomyo-matosis (LAM). MATERIAL AND METHODS: One patient with TSC-LAM (tuberous sclerosis complex lymphangioleiomyomatosis) participated in two weekly sessions (50-60 min) of supervised aerobic exercise at 80-85% heart rate max for one year. Treadmill ergometry (VO2peak), spirometry (FEV1, FVC, FEV1/FVC, peak flow), and bone mineral density testing were performed prior to every 3 months. RESULTS: After one year of supervised aerobic exercise training we saw dramatic increases in the patient's VO2max (20%), FEV1 (9.5%), FEV1/FVC (9.1%) and peak flow (47%). CONCLUSIONS: The results from this study indicate that supervised exercise training can improve exercise tolerance and pulmonary function in a patient with lymphangioleiomyomatosis. Further research is needed, including longitudinal studies with larger sample sizes, to determine long-term effects and consistency of these findings. Aerobic exercise may offer a viable alternative or com-pliment to pharmacological interventions in the treatment of lymphangioleiomyomatosis. We show that high-intensity exercise training can markedly and safely improve pulmonary function in a patient with TSC-LAM. While we did not record quality of life or mood states, our patient did report improved self-confidence as well as enhanced mood.