Effects of Combined Exercise on Hypoalgesia and Autonomic Variables in a Patient with Hypermobile Ehlers-Danlos Syndrome: A Case Study

Ehlers-Danlos syndromes (EDS) are a heterogeneous group of connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. In addition to experiencing chronic pain, musculoskeletal injuries, and recurrent dislocations, their condition often involves symptoms related to dysautonomia, which can dominate the pathology and lead to significant disability. A 26-year-old woman diagnosed with hypermobile EDS with chronic pain and dysautonomia symptoms of 3 years' duration was evaluated. Pain pressure thresholds, heart rate, peripheral skin temperature, and skin conductance were assessed during a Tilt Test and modified Bruce protocols for this study. Two measurements were taken, one before and one after 7 weeks of treatment. The treatment, based on interval-type cardiovascular exercise and general strength training, produced significant changes in all the variables mentioned above. Decreases in heart rate, temperature, and skin conductance were observed, as well as an increase in pain pressure thresholds in certain cases. The results of this case may indicate that an exercise-based intervention is capable of producing changes in variables related to the autonomic nervous system and descending pain modulation systems in a patient diagnosed with hypermobile EDS.