Which physiotherapy method is more effective for hand rehabilitation in patients with scleroderma: Physiotherapist-guided telerehabilitation or independent home-based exercise program?

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.