Effects of Rhythmic Sensory Stimulation on Ehlers–Danlos Syndrome: A Pilot Study

Abstract

Ehlers–Danlos syndrome (EDS) is a connective tissue disorder characterized by joint hypermobility and skin extensibility and is often accompanied by chronic pain. Rhythmic sensory stimulation (RSS) can be defined as the stimulation of the senses in a periodic manner within a range of low frequencies. Music plus sound delivered through a vibroacoustic device is a form of RSS and has demonstrated utility in managing pain. In this current study, we conducted an open-label pilot study of 15 patients with hypermobile EDS using RSS as the intervention. Posttreatment improvements were seen in 11 of the 15 patients (73%), whereas 3 of the 15 patients (20%) experienced worse outcomes. Of the 14 patients that completed the experiment, 6 participants (43%) were classified as “responders” to the device while 8 participants (57%) were classified as “nonresponders.” Responders demonstrated significant improvements in pain interference (51.5 ± 16 preintervention vs. 43.5 ± 16.4 postintervention BPI score) and depression symptoms (34.0 ± 15.9 preintervention vs. 26.8 ± 12.1 postintervention CESD score). Poststudy interviews confirm the improvements of pain interference, mood, and bowel symptoms. Furthermore, analysis of medical conditions within the responder group indicates that the presence of depression, anxiety, irritable bowel syndrome, and fibromyalgia may indicate a greater likelihood for patients to benefit with vibroacoustic applications. These results indicate a possible potential for RSS, delivered using a vibroacoustic device, in managing pain-related symptoms. Further research is necessary to elucidate the exact mechanism behind the physiological benefits of RSS.

Exploring vibroacoustic therapy in adults experiencing pain: a scoping review

“…During the updated search (conducted on 9 January 2022), we found three research studies (one double-blind RCT pilot study,37 one pretest post-test study without a control group,38 one case study)39 and one RCT protocol published at ClinicalTrial.gov. The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37.…”

“…During the updated search (conducted on 9 January 2022), we found three research studies (one double-blind RCT pilot study,37 one pretest post-test study without a control group,38 one case study)39 and one RCT protocol published at ClinicalTrial.gov. The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37. Interventions were delivered using the Sound Oasis VTS1000 using the ‘Energise’ programme,38 a wearable music player (XINYIBAO),39 and a PaciniMedico ApS chair device playing rhythmically aligned music 37.…”

“…The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37. Interventions were delivered using the Sound Oasis VTS1000 using the ‘Energise’ programme,38 a wearable music player (XINYIBAO),39 and a PaciniMedico ApS chair device playing rhythmically aligned music 37. All studies reported improvements on pain sensation due to the intervention (although Eshuis et al 37 also reported significant improvements in the active control group).…”

Possible Mechanisms for the Effects of Sound Vibration on Human Health

“…For studies in WBV the entire body is stimulated but the actual vibratory transmission can be dependent on posture and stance. With vibroacoustic stimulation devices, the application can be almost the entire body with speakers above the knee, lower back, upper back, and neck [ 40 ] or primarily the back with a single transducer in the centre of the back [ 41 ], or only hands and feet with small piezoelectric devices [ 247 ], or as small as a pencil-like probe [ 32 , 147 ]. Therefore, we recommend to add a sixth reporting category: (6) the region of the body that is directly stimulated by vibration (e.g., spine, low back, neck, feet, and whole-body).…”

“…Within the brain, vibration hypothetically enhances flow of cerebrospinal fluid and speeds removal of metabolic waste [ 39 ]. Most research with VAT has not explored neural oscillatory effects but recent studies show [ 40 , 41 , 42 , 43 , 44 ] potential brain effects, especially through prolonged application of a single frequency (e.g., 40 Hz).…”