The Effect of Physiotherapy Program in Scleroderma Patients
Condition: Scleroderma; Systemic Sclerosis; Hand Rheumatism; Physiotherapy; Rehabilitation
MeSH terms: Rheumatic Diseases; Scleroderma, Systemic; Scleroderma, Diffuse; Scleroderma, Localized; Sclerosis
Study type: Interventional

Summary: 
      The aim of this study was to investigate the effectiveness of physiotherapy and
      rehabilitation program on hand involvement of patients with scleroderma and to compare the
      effects of home rehabilitation program and rehabilitation program under physiotherapist
      supervision. At the end of the study, the rehabilitation program under the supervision of
      physiotherapist and home exercise program will be compared with the effects of these
      applications on range of motion, grip strength, function and sensation. Since there are a
      limited number of randomized controlled studies in the literature on this subject and there
      is no randomized controlled clinical study on the superiority of physiotherapist supervision
      and home program, it will contribute to the information regarding the rehabilitation of
      scleroderma patients.
    

Detailed description: 
      Scleroderma is an autoimmune connective tissue disease with fibrosis. Although its etiology
      and pathogenesis have not been clearly defined, it has a chronic course. It is estimated that
      scleroderma affects approximately 300,000 people in the United States. Most commonly, it
      affects adults and women.

      When the current literature is examined, Landim et al. in their studies for the development
      and evaluation of hand exercises home program in patients with systemic scleroderma; They
      found that the 8-week home exercise program had positive effects on pain, function, mobility
      and strength. Antonioli et al. concluded that individualized rehabilitation program could
      improve quality of life and hand mobility in patients with systemic sclerosis. Lopes et al.
      found that the degree of physical disability was related to both hand grip strength and
      pulmonary function, but there was no relationship between hand grip strength and pulmonary
      function in these patients. Mancuso et al. In their case series studies examining the effect
      of paraffin and exercise on hand functions in scleroderma, they concluded that paraffin and
      hand exercises can be used to improve hand functions related to participation in daily
      activities. Rannou et al. in their study comparing the effects of physical therapy program
      and the usual care of patients with systemic sclerosis on disability, they concluded that
      1-month individualized supervised physical therapy program followed by home exercise programs
      provided short-term benefit. Bongi et al. systemic scleroderma patients with general
      rehabilitation programs applied to the hand and face specific programs designed to evaluate
      the effectiveness of their studies; have shown that these techniques improve disability,
      HRQoL, hand and face functionality.

      A limited number of studies in the literature emphasize the need for more research with
      larger sample size and more variable control.

      The aim of this study was to investigate the effectiveness of physiotherapy and
      rehabilitation program on hand affected patients with scleroderma diagnosis and to compare
      the effects of home exercise program with physiotherapist supervision. At the end of the
      study, the rehabilitation program under the supervision of physiotherapist will be compared
      with the home exercise program and data on the effects of these applications on range of
      motion, grip strength, function and sensation will be obtained; their superiority to each
      other will be revealed.
    

Intervention name(s): Hand Therapy by Physiotherapist; Hand Therapy as home program
Intervention type(s): Other; Other
Intervention description(s): stretching exercises; all finger joints, wrist and supination-pronation direction strengthening exercises; finger and wrist functional exercises retrograde massage; starting from the distal phalanx to the elbow sensory education; desentilation training (cotton…) breathing exercises 5 days / week, 8 weeks in total
3 days / week with physiotherapist
2 days / week as home program 30 minutes / day 12 repetitions; stretching exercises; all finger joints, wrist and supination-pronation direction strengthening exercises; finger and wrist functional exercises retrograde massage; starting from the distal phalanx to the elbow sensory education; desentilation training (cotton…) breathing exercises 5 days / week, 8 weeks in total
3 days / week with physiotherapist
2 days / week as home program 30 minutes / day 12 repetitions
Other intervention name(s): Physiotherapy and Rehabilitation; Physiotherapy and Rehabilitation
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized Clinical Study
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Scleroderma; Systemic sclerosis; Hand therapy