Which physiotherapy method is more effective for hand rehabilitation in patients with scleroderma: Physiotherapist-guided telerehabilitation or independent home-based exercise program?
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Abstract
Background: Although exercise is known to be important in treating scleroderma patients, studies on the methods by which exercise should be performed are limited.
Purpose: This study aimed to compare the effects of physiotherapist-guided telerehabilitation and independent home-based exercise treatments for hand rehabilitation in patients with scleroderma.
Study design: Randomized controlled trial.
Methods: Patients diagnosed with scleroderma were randomized into two groups. While patients in the telerehabilitation group did their exercises under the supervision of a physiotherapist using the Zoom application, patients in the home-based exercise group did the exercises in the brochure given to them on their own. The treatment of both groups was 3 days a week for 8 weeks and included similar exercises. Hand mobility, thumb mobility, finger motion, gross and pinch grip strength, pain intensity, hand functions, health status, and quality of life of the patients were evaluated before and after treatment.
Results: Thirty-four patients were included in the study. No significant difference was detected between the groups due to baseline evaluation. After 8-week treatment, telerehabilitation group demonstrated better hand mobility (p = 0.010, d = -0.31; p = 0.015, d = -0.17), thumb mobility (p < 0.001, d = 0.54; p < 0.001, d = 0.48), finger motion (p = 0.005, d = -0.35; p = 0.005, d = -0.41), gross grip strength (p < 0.001, d = 0.52; p = 0.007, d = 0.35), and triple (p = 0.002, d = 0.76; p = 0.011, d = 0.62) and lateral pinch grip strength (p = 0.008, d = 0.09; p = 0.024, d = 0.17) scores for right and left hands, respectively.
Conclusions: The present research indicated that physiotherapist-guided telerehabilitation is more effective than self-management in hand rehabilitation in patients with scleroderma. Based on these findings, physiotherapist-guided telerehabilitation is a quality practice that has the potential to increase hand mobility and grip strength in patients with scleroderma.
背景：虽然运动在治疗硬皮病患者中很重要，但关于运动方法的研究却很有限。目的：本研究旨在比较物理治疗师指导的远程康复和独立的家庭运动治疗对硬皮病患者手部康复的效果。研究设计：随机对照试验。方法：将诊断为硬皮病的患者随机分为两组。远程康复组的患者在理疗师的监督下使用Zoom应用程序进行锻炼，而家庭锻炼组的患者则根据发给他们的小册子进行锻炼。两组治疗均为每周3天，连续8周，包括相似的运动。评估患者治疗前后的手部活动度、拇指活动度、手指活动度、总握力和捏握力、疼痛强度、手功能、健康状况和生活质量。结果：34例患者纳入研究。由于基线评估，各组之间未发现显著差异。8周治疗后,telerehabilitation集团展示了更好的手移动(p = 0.010, d = -0.31; p = 0.015, d = -0.17),拇指移动(p < 0.001, d = 0.54, p < 0.001, d = 0.48),手指运动(p = 0.005, d = -0.35; p = 0.005, d = -0.41),握力总值(p < 0.001, d = 0.52; p = 0.007 d = 0.35)和三(p = 0.002, d = 0.76; p = 0.011, d = 0.62)和横向夹握力(p = 0.008, d = 0.09; p = 0.024, d = 0.17)分数的右手和左手,分别。结论：在硬皮病患者手部康复中，物理治疗师指导的远程康复比自我管理更有效。基于这些发现，物理治疗师指导的远程康复是一种高质量的实践，有可能增加硬皮病患者的手部活动能力和握力。
期刊介绍：
The Journal of Hand Therapy is designed for hand therapists, occupational and physical therapists, and other hand specialists involved in the rehabilitation of disabling hand problems. The Journal functions as a source of education and information by publishing scientific and clinical articles. Regular features include original reports, clinical reviews, case studies, editorials, and book reviews.
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