ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 739

How Effective Is the Home Exercise Program for Hands in Patients with Systemic Sclerosis: Preliminary Results from a Randomized Controlled, Single-Blind, Clinical Trial

Neslihan Gokcen1, Suade Ozlem Badak2, Tunay Sarpel3, Yasar Sertdemir4 and Eren Erken2, 1Physical Medicine and Rehabilitation, Division of Rheumatology, Cukurova University School of Medicine, Adana, Turkey, 2Internal Medicine, Division of Rheumatology, Cukurova University School of Medicine, Adana, Turkey, 3Physical Medicine and Rehabilitation, Cukurova University School of Medicine, Adana, Turkey, 4Department of Biostatistics and Medical Informatics, Cukurova University School of Medicine, Adana, Turkey

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: depression, exercise, Hand function, Quality of life and systemic sclerosis

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 5, 2017

Session Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's – Clinical Aspects and Therapeutics Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Systemic sclerosis (SSc) represents a heterogeneous autoimmune disease characterized by fibrosis of skin and internal organs. In particular, thickening of the skin, puffy hands, digital ulcers, calcinosis and joint contractures has contributed to disease prognosis by decreasing function of the hand and quality of life. The present study aims to investigate the effectiveness of the hand exercise program and demonstrate its influence on quality of life, as well as anxiety and depression in SSc patients.

Methods: Thirty female patients with SSc who fulfilled the 2013 ACR/EULAR classification criteria for systemic sclerosis were included in the study. Patients with neurological disorders, arthritis, myositis, amputation of fingers, serious contracture resisting hand grip and history of undergoing hand surgery were excluded. Patients were randomized into an exercise (n=16) and a control (n=14) group. Each group were informed of their disease and given recommended advice such as avoiding cold and trauma. The exercise group participated in a single hand exercise training applied by a medical doctor. Hereafter, they were given instructions for the home exercise program. The 8-week intervention consisted of isometric hand exercise and self-administered stretching repeated 10 times/2 set of training exercises per a day. Each group’s hand functions were assessed by Hand Mobility in Scleroderma (HAMIS) and Duruöz Hand Index (DHI). Additionally, all patients were estimated by Short Form 36 (SF-36), The Health Assessment Questionnaire (HAQ), Beck Anxiety and Beck Depression Inventory. Each group were evaluated at baseline and reassessed after 4 (V1) and 8 (V2) weeks.

Results: The baseline demographics and disease characteristics between the groups were similar. When comparing V1 and V2, we established a statistically significant amelioration from baseline measurement of handgrip strength in the exercise group (p<0.001). Accordingly, values of HAMIS, DHI, HAQ and Beck Depression Inventory were also significantly improved at V2 (p=0.002, 0.001, 0.001, 0.071, respectively) (Table). The assessment between the two groups at V1 and V2 indicated significant improvement in the exercise group with respect to the controls.

Conclusion: Exercise therapy showed a greater amelioration in the patients’ measurements of handgrip strength, quality of life and depression in SSc patients, indicating improvement in their hand function when compared to the control group.

Table: Outcome measurement changes in between the two groups at baseline, after 4 week and 8 week.

Outcome

Baseline

mean±SD

median (min-max)

Week 4

mean±SD

median (min-max)

Week 8

mean±SD

median (min-max)

ptime

Modified Rodnan Skin Score

E

15.4±8.1

14 (4-33)

14.3±7.2

12.0 (5-32)

13.6±6.6

11.5 (5-30)

0.026*

C

15.1±8.8

13.5 (3-34)

14.7±8.0

13.5 (3-30)

14.9±8.1

14.0 (4-30)

0.830

pgroup

0.697

0.728

0.667

HAMIS

E

5.3±6.0

4.5 (0-18)

2.5±4.8

0 (0-14)

1.9±3.5

0 (0-13)

0.002¶

C

4.0±5.2

3.0 (0-19)

4.0±4.6

2.5 (0-13)

4.0±5.2

2.5 (0-18)

0.968

pgroup

0.608

0.208

0.257

DHI

E

8.0±6.0

5.0 (0-29)

5.3±6.8

3.5 (0-22)

4.1±6.7

1.0 (0-18)

<0.001§

C

13.7±13.4

7.0 (0-35)

14.9±13.3

15.0 (0-32)

15.1±11.7

16.5 (0-30)

0.734

pgroup

0.525

0.101

0.013

Valentini activity score

E

2.4±1.4

2.0 (0.5-5)

1.5±1.4

1.0 (0-4.5)

1.2±1.0

1.3 (0-3.5)

<0.001§

C

3.4±1.5

3.3 (1-6)

2.3±0.9

2.0 (0.5-4)

2.3±1.8

2.0 (0-6)

0.048*

pgroup

0.110

0.028*

0.064

Beck Depression Inventory

E

19.8±11.6

18.0 (2-46)

18.0±11.3

18.5 (3-39)

15.0±11.2

12.5 (2-45)

0.035*

C

23.1±10.3

22.5 (3-40)

23.0±11.6

24.5 (4-50)

23.7±11.9

25.0 (0-42)

0.910

pgroup

0.294

0.240

0.034*

Beck Anxiety Inventory

E

16.3±9.2

15.0 (3-36)

17.0±10.1

14.5 (6-41)

13.4±10.2

9.5 (1-40)

0.071

C

25.9±10.3

27.5 (6-39)

23.4±11.9

22.5 (4-50)

22.1±11.7

23.0 (1-46)

0.233

pgroup

0.010*

0.093

0.034*

Dominant handgrip strength (kg)

E

18.6±6.7

18.0 (10-32)

22.3±7.1

20.5 (14-36)

24.6±6.8

23.5 (14-38)

<0.001§

C

15.5±6.4

18.0 (11-30)

18.7±6.8

18.0 (9-30)

18.4±6.4

17.5 (9-30)

0.843

pgroup

0.984

0.244

0.013*

HAQ

E

10.5±7.7

9.0 (0-26)

6.3±7.8

2.5 (0-23)

4.1±6.2

0 (0-18)

<0.001§

C

13.6±13.3

8.0 (0-40)

13.8±12.5

7.0 (0-35)

13.7±11.7

8.5 (0-32)

0.967

pgroup

0.822

0.093

0.007¶

SF-36

Physical function

E

43.8±25.0

42.5 (5-90)

53.4±21.9

50.0(20-100)

67.8±17.1

67.5(30-100)

<0.03*

C

46.8±31.4

45.0 (0-100)

39.6±34.5

35.0 (0-100)

37.9±30.8

40.0 (0-100)

0.312

pgroup

0.886

0.257

0.003¶

Role physical

E

20.3±32.0

0 (0-100)

40.6±38.6

25.0 (0-100)

55.0±38.1

50.0 (0-100)

<0.001§

C

14.3±27.2

0 (0-100)

17.9±28.5

0 (0-100)

25.0±39.2

0 (0-100)

0.343

pgroup

0.759

0.077

0.038*

Body pain

E

56.8±32.3

60.5 (0-100)

56.3±19.7

56.0 (30-84)

60.0±21.0

60.0 (22-90)

0.853

C

52.7±29.6

50.5 (0-90)

53.5±26.0

60.0 (10-90)

55.0±29.0

61.0 (0-100)

0.881

pgroup

0.728

0.822

0.749

General health

E

44.7±20.5

50.0 (0-67)

45.1±17.0

45.0 (10-70)

46.1±18.3

50.0 (15-75)

0.917

C

44.4±24.5

47.5 (0-80)

39.7±23.9

47.5 (0-65)

34.8±22.7

46.0 (0-60)

0.016*

pgroup

0.886

0.759

0.224

Vitality

E

45.9±17.7

50.0 (10-70)

43.4±17.5

40.0 (15-75)

48.4±15.0

50.0 (20-75)

0.488

C

34.3±18.6

37.5 (0-60)

39.6±18.1

42.5 (5-65)

38.6±21.0

45.0 (0-70)

0.281

pgroup

0.093

0.728

0.257

Social functioning

E

44.5±20.9

50.0 (0-75)

42.9±14.6

50.0 (12-63)

46.7±21.0

50.0(13-100)

0.842

C

37.4±22.5

37.5 (0-75)

43.0±19.5

50.0 (0-75)

37.0±14.4

37.0 (12-62)

0.524

pgroup

0.142

0.142

0.142

Role emotional

E

33.2±36.5

33.0 (0-100)

43.7±20.3

33.0 (0-67)

47.8±21.2

33.0(33-100)

0.214

C

33.1±34.5

33.0 (0-100)

30.7±27.5

33.0 (0-100)

40.4±32.6

33.0 (0-100)

0.426

pgroup

0.951

0.101

0.400

Mental health

E

54.5±16.8

54.0 (16-80)

51.3±18.1

50.0 (28-96)

48.4±17.5

54.0 (36-96)

0.256

C

47.4±16.3

46.0 (16-72)

49.4±8.7

50.0 (36-68)

47.4±15.4

50.0 (20-68)

0.905

pgroup

0.240

0.886

0.208

*p<0.05, ¶p<0.01, §p<0.001

E: Exercise group, C: Control group, HAMIS: Hand Mobility in Scleroderma, DHI: Duruöz Hand Index, HAQ: The Health Assessment Questionnaire, SF-36: Short Form 36.


Disclosure: N. Gokcen, None; S. O. Badak, None; T. Sarpel, None; Y. Sertdemir, None; E. Erken, None.

To cite this abstract in AMA style:

Gokcen N, Badak SO, Sarpel T, Sertdemir Y, Erken E. How Effective Is the Home Exercise Program for Hands in Patients with Systemic Sclerosis: Preliminary Results from a Randomized Controlled, Single-Blind, Clinical Trial [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/how-effective-is-the-home-exercise-program-for-hands-in-patients-with-systemic-sclerosis-preliminary-results-from-a-randomized-controlled-single-blind-clinical-trial/. Accessed February 3, 2023.
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/how-effective-is-the-home-exercise-program-for-hands-in-patients-with-systemic-sclerosis-preliminary-results-from-a-randomized-controlled-single-blind-clinical-trial/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences