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The effect of a 24-week physiotherapy and occupational therapy program in systemic sclerosis: a monocentric controlled study with follow-up
M. Špiritović1, H. Šmucrová2, B. Heřmánková3, S. Oreská4, H. Štorkánová5, A. Rathouská6, P. Česák7, M. Komarc8, O. Růžičková9, V. Bunc10, K. Pavelka11, J. Vencovský12, L. Šenolt13, R. Bečvář14, M. Tomčík15
- Institute of Rheumatology, Prague, and Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, Czech Republic.
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, Czech Republic.
- Department of Human Movement Laboratory, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Department of Human Movement Laboratory, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
- Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic. tomcik@revma.cz
CER15092
2022 Vol.40, N°10
PI 1941, PF 1950
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PMID: 35200131 [PubMed]
Received: 23/08/2021
Accepted : 17/12/2021
In Press: 22/02/2022
Published: 17/10/2022
Abstract
OBJECTIVES:
The structural and functional changes of the hands and face in systemic sclerosis (SSc) can be severely disabling. We aimed to assess the effect of a 24-week supervised physiotherapy and occupational therapy program (POTp) combined with home exercise on the function of hands/mouth of SSc patients, compared to a daily home exercise program in typical outpatient care.
METHODS:
Fifty-nine patients with SSc were consecutively and non-selectively enrolled in an intervention (IG, n=27) or control (CG, n=32) group. Only the IG underwent the POTp twice a week for 1.5 hours. At baseline, 12, 24, and 48 weeks, all patients were assessed by a blinded physiotherapist for the hands/mouth function (delta finger-to-palm, handgrip strength, Hand and Mobility in Scleroderma, interincisal/interlabial distance), and self-evaluated their hand (Cochin Hand Function Scale) and mouth function (Mouth Handicap in Systemic Sclerosis scale), disability (Health Assessment Questionnaire [HAQ], SSc HAQ), and quality of life (Short Form-36).
RESULTS:
At week 24, compared to the significant deterioration in the CG, we found a significant improvement in the IG in the objectively assessed hands/mouth function and in the subjectively evaluated hand function and disability. The improvement was clinically meaningful (by >20%) in a substantial proportion of patients. Although the improvement in most outcomes was still present at week 48, the maximum effect was not sustained.
CONCLUSIONS:
This 24-week POTp not only attenuated the progressive deterioration, but also significantly improved the function of the hands/mouth, which was clinically meaningful in a substantial proportion of patients with SSc.
