Foundational Projects

The Impact of Underinvestment in Ehlers-Danlos Syndrome: 

EDS is under-recognized, and the variety of skeletal and visceral manifestations under-appreciated. This leads to delays in diagnosis, misdiagnoses, inappropriate interventions and poor treatment outcomes. The direct and indirect costs to patients, third-parties and government are substantial. This study assesses the baseline state of provider knowledge, patient access to appropriate care, and the costs of inadequacies to both patients and society.

Identifying Appropriate Clinical Outcome Measures for People with Ehlers-Danlos Syndrome: 

Creating a set of standardized outcome measures is instrumental to evaluating the health of patients with EDS and the effects of interventions. Areas of interest include general function, pain, upper extremity function, balance, mobility, mast cell activation symptoms, dysautonomia, cognition and mood. The purpose of this study is to provide evidence-based recommendations for OM use in clinical practice, education, and research specific to individuals with EDS.  

Research to Advance Diagnosis and Treatment

EDSRF FLAGSHIP PROJECT: Prospective study of efficacy of a multidisciplinary musculoskeletal approach in increasing functionality and decreasing symptom frequency and severity in EDS

At PRISM Spine and Joint, Dr. Zingman is pioneering a unique, multidisciplinary treatment approach for EDS/HSD treatment, using a combination of osteopathic manipulation, craniosacral and myofascial techniques, tailored physical therapy, and other techniques. The purpose of this study is to determine the effectiveness of this approach, enrolling at least 100 EDS patients and measuring their progress over 12 months.

Analysis of Micronutrient Tests for Nutritional Deficiencies in Patients with Ehlers-Danlos Syndrome: 

Many symptoms associated with EDS, such as hypermobility and susceptibility to bruising and bleeding, are characteristic of low levels of essential nutrients. Inflammation of the stomach and small intestine, common in EDS, is known to result in malnutrition. The purpose of this study is to identify the most common nutritional deficiencies in individuals with EDS as a starting point for potential therapeutic targeting.

Utility of Supine vs. Upright vs. Upright Flexion/Extension C Spine Imaging in Image-Guided Diagnosis of Craniocervical Instability (CCI):

Craniocervical instability, or increased mobility in the craniocervical junction, is common in hypermobility syndromes such as EDS. It can be debilitating or even life-threatening. However, the condition is often missed on imaging. The purpose of this study is to determine the utility of three imaging positions in identifying Craniocervical Instability (CCI): supine vs. upright vs. upright dynamic imaging (flexion/extension) . 

The Effect of Osteopathic Manipulative Treatments on Hand Strength and Function:

Patients with EDS often have hand weakness. This could be attributed to cervical dysfunction/pathology or to joint position discrepancies/subluxations in the upper extremities. Osteopathic Manipulative Treatments (OMT) have long been used to ease pain, promote healing, and restore alignment. The purpose of this study is to determine the efficacy of upper extremity OMT in improving hand strength and function.

Additional Areas of Interest

  • Ribcage biomechanical dysfunction and the effects on lung capacity; shoulder, sacroiliac joint, and hip stability; anxiety; autonomic function and cerebrospinal fluid flow
  • Techniques to improve sagittal balance and the effect on functional status, pain, tethered cord syndrome, autonomic dysfunction and immune function
  • Non-surgical management and improved surgical outcomes: Craniocervical Instability; Atlantoaxial Instability; Anterolisthesis; Shoulder Instability; Hip Instability; etc.
  • The diagnosis and treatment of elbow, wrist, hand, knee, ankle, and foot subluxations and their effects on peripheral nerve function and pain
  • The role of the temporomandibular joint and jaw musculature in upper cervical instability; diagnosis and treatment of temporomandibular joint dysfunction
  • The role of mast cell dysfunction in joint instability and dysautonomia; screening, diagnosis and treatment of mast cell dysfunction and other immunologic disorders in EDS patients
  • The efficacy of lifestyle modifications, psychologic support techniques, nutritional interventions and supplements in supporting connective tissue and autonomic nervous system function
  • Regenerative medicine and other biomedical approaches to support connective tissues