Effects of a 12-week physiotherapist-supervised home-based rehabilitation program on the functional exercise capacity in people with systemic sclerosis.
Samantha Gomes de Alegria, Matheus Mello da Silva, Beatriz Luiza Pinheiro Alves Azevedo, Jéssica Gabriela Messias Oliveira, Iasmim Maria Pereira Pinto Fonseca, Isabelle da Nóbrega Ferreira, Patrícia Frascari Litrento, Cláudia Henrique da Costa, Agnaldo José Lopes
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Abstract
Objective: There is still a wide variation in the rehabilitation programs developed for systemic sclerosis, which makes it urgent to develop feasible and easy-to-use protocols using tools capable of measuring the response to rehabilitation. The Glittre-ADL test assesses functional exercise capacity using activities of daily living and is useful due to the hands involvement. This study aimed to evaluate the effects of a physiotherapist-supervised home-based rehabilitation program on functional exercise capacity in women with systemic sclerosis using the Glittre-ADL test. A secondary aim was to evaluate the association between the Glittre-ADL test and handgrip strength, hand function, physical function, quality of life, and lung function.
Methods: This is a quasi-experimental study in which 33 women with systemic sclerosis underwent a physiotherapist-supervised home-based rehabilitation program for 12 weeks. The following pre- and post-physiotherapist-supervised home-based rehabilitation program assessments were performed: Glittre-ADL test, Health Assessment Questionnaire Disability Index, Cochin Hand Functional Scale, Short Form 36 Health Survey, handgrip strength, and spirometry.
Results: There was a significant increase in Glittre-ADL test time after physiotherapist-supervised home-based rehabilitation program (p = 0.036). There was a significant decrease in manual time of the Glittre-ADL test between pre- and post-physiotherapist-supervised home-based rehabilitation program (p = 0.001). For Health Assessment Questionnaire Disability Index, there was a significant decrease from 1.13 (0.5-1.8) points before physiotherapist-supervised home-based rehabilitation program to 1.0 (0.4-1.3) points after physiotherapist-supervised home-based rehabilitation program (p = 0.004). For the Cochin Hand Functional Scale, there was a decrease from 14 (5-35) points before physiotherapist-supervised home-based rehabilitation program to 7 (3-21) points after physiotherapist-supervised home-based rehabilitation program (p = 0.0002). There was a significant increase in handgrip strength between pre- and post-PHPR (p = 0.008). The delta for Glittre-ADL test time (%predicted) was significantly correlated with the delta for handgrip strength (rs = -0.360, p = 0.039).
Conclusion: After physiotherapist-supervised home-based rehabilitation program, women with systemic sclerosis require less time to complete the Glittre-ADL test tasks. Physiotherapist-supervised home-based rehabilitation program improves manual function, physical function, handgrip strength, lung function, and quality of life. There is a relationship between Glittre-ADL test time and handgrip strength. These results suggest that a 12-week physiotherapist-supervised home-based rehabilitation program could be a beneficial non-pharmacological therapy that reduces functional limitations and improves quality of life in systemic sclerosis.
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