Abstract
Rehabilitation may contribute to the management of systemic sclerosis (SSc) dealing with disabilities due to hand involvement. The aim of this study is to evaluate the efficacy of a rehabilitation programme based on the combination of connective tissue massage and Mc Mennell joint manipulation specifically conceived for SSc patients’ hands. Forty SSc patients were enrolled: 20 (interventional group) were treated for a 9-week period (twice a week, 1 h per session) with a combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme, and 20 (control group) were assigned only to home exercise programme. Patients of both groups were assessed at baseline (T0), after 9 week (T1) and at a 9 weeks follow-up (T2). They were evaluated for quality of life by SF-36 and Health Assessment Questionnaire (HAQ), hands involvement by Hand Mobility in Scleroderma (HAMIS) test, Cochin hand functional disability scale and the measurements of ROM. In the interventional group, fist closure, HAMIS test and Cochin hand functional disability scale improved at the end of the treatment (p < 0.0001) as well as HAQ, Physical Synthetic Index (PSI) and Mental Synthetic Index (MSI) of SF-36 scores (HAQ and PSI, p < 0.0001; MSI, p < 0.001). In the control group, the programme of home daily exercises improved only fist closure at the end of the treatment (p < 0.0001). The combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme is effective in the rehabilitative treatment of SSc hands. This combined treatment may lead to an improvement of hand function and quality of life.
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Wigley FM (1998) Systemic sclerosis: clinical features. In: Klippel JH, Dieppe PA (eds) Rheumatology. Mosby, London, p 7.9.1
Casale R, Buonocore M, Matucci-Cerinic M (1997) Systemic sclerosis (scleroderma): an integrated challenge in rehabilitation. Arch Phys Med Rehabil 78:767–773
Ranque B, Authier FJ, Berezne A, Guillevin L, Mouthon L (2007) Systemic sclerosis-associated myopathy. Ann N Y Acad Sci 1108:268–282
Matucci-Cerinic M, Steen VD, Furst DE, Seibold JR (2007) Clinical trials in systemic sclerosis: lessons learned and outcomes. Arthritis Res Ther 9(Suppl 2):S7
Matucci Cerinic M, Del Rosso A, Perfetto F, Livi R et al (2007) Therapeutic challenges for systemic sclerosis: facts and future targets. Ann N Y Acad Sci 1110:448–454
Maddali Bongi S, Landi G, Sigismondi F, Pimpinella F et al. (2005) Connective massage and Mc Mennell joint manipulation may improve the function of Scleroderma (SSc) hand. Arthr Rheum 52(suppl):S586 (abstract 1566)
Matucci-Cerinic M, Maddali Bongi S, Landi G et al (2007) Association of Kabat's technique, connective massage and kinesitherapy in the rehabilitative treatment of systemic sclerosis face. International Workshop on Scleroderma, May 18–20, Tokyo, Japan, abstr. 091, p. 94
Matucci-Cerinic M, Maddali Bongi S, Passalacqua M, Tai G et al (2007) Manual lymph drainage for the treatment of edematous hand in systemic sclerosis. International Workshop on Scleroderma, May 18–20, Tokyo, Japan, abstr.046, p. 71
Tuffanelli DL, Winkelmann RK (1961) Systemic scleroderma: a clinical study of 727 cases. Arch Dermatol 84:359–371
Baron M, Lee P, Keistone EC (1982) The articular manifestations of progressive systemic sclerosis (scleroderma). Ann Rheum Dis 41:147–152
Erre GL, Marongiu A, Fenu P, Faedda R, Masala A, Sanna M et al (2008) The "sclerodermic hand": a radiological and clinical study. Jt Bone Spine 75:426–431
Misra R, Darton K, Jewkes RF, Black CM, Maini RN (1995) Arthritis in scleroderma. Br J Rheumatol 34:831–837
Pope JE (2003) Musculoskeletal involvement in scleroderma. Rheum Dis Clin North Am 29:391–408
Antonioli CM, Bua G, Frigè A, Prandini K, Radici S, Scarsi M et al (2009) An individualized rehabilitation program in patients with systemic sclerosis may improve quality of life and hand mobility. Clin Rheumatol 28(2):159–165
Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590
Bombardieri S, Medsger TA Jr, Silman AJ, Valentini G (2003) The assessment of patient with systemic sclerosis. Clin Exp Rheumatol 21(3 Suppl 29): S2–4
Kisner C, Colby LA (2002) Therapeutic exercise: foundations and techniques, 4th edn. Davis, Philadelphia
Goats GC, Keir KA (1991) Connective tissue massage. Br J Sports Med 25:131–133
Alpiner N, Oh TH, Hinderer SR, Brander VA (1995) Rehabilitation in joint and connective tissue diseases. 1. Systemic diseases. Arch Phys Med Rehabil 75:S32–S40
Greenman PE (2003) Mobilization with and without impulse technique. Principles of manual medicine, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 107–112
Apolone G, Cifani S, Mosconi P (1997) Questionario sullo stato di salute SF-36. Traduzione e validazione della versione italiana: risultati del progetto IQOLA. Medic 2:86–94
La Montagna G, Cuomo G, Chiarolanza I, Ruocco L, Valentini G (2006) HAQ-DI Italian version in systemic sclerosis. Reumatismo 58(2):112–115
Sandqvist G, Eklund M (2000) Hand Mobility in Scleroderma (HAMIS) test: the reliability of a novel hand function test. Arthritis Care Res 13:369–374
Poiraudeau S, Chevalier X, Conrozier T, Flippo RM, Lioté F, Noël E et al (2001) Reliability, validity, and sensitivity to change of the Cochin hand functional disability scale in hand osteoarthritis. Osteoarthr Cartil 9:570–577
Sandqvist G, Eklund M, Akesson A, Nordenskiöld U (2004) Daily activities and hand function in women with scleroderma. Scand J Rheumatol 33:102–107
Poole JL, Watzlaf VJ, D'Amico F (2004) A five-year follow up of hand function and activities of daily living in systemic sclerosis (scleroderma). J Hand Ther 17:407–411
Blocka KLN (2004) Musculoskeletal involvement in systemic sclerosis. In: Clements PJ, Furst D (eds) Systemic sclerosis, 2nd edn. Williams & Wilkins, Baltimore, pp 249–260
Steen VD, Medsger TA Jr (1997) The palpable tendon friction rub: an important physical examination finding in patients with systemic sclerosis. Arthritis Rheum 40:1146–1151
Kuwana M, Sato S, Kikuchi K, Kawaguchi Y, Fujisaku A, Misaki Y et al (2003) Evaluation of functional disability using the health assessment questionnaire in Japanese patients with systemic sclerosis. J Rheumatol. 30:1253–1258
Dagfinrud H, Kvien TK, Hagen KB (2008) Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev 23:CD002822
Bodenheimer T, Lorig K, Holman H, Grumbach K (2002) Patient self management of chronic disease in primary care. JAMA 288:2469–2475
Mugii N, Hasegawa M, Matsushita T, Kondo M et al (2006) The efficacy of self-administered stretching for finger joint motion in Japanese patients with systemic sclerosis. J Rheumatol 33:1586–1592
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This work is promoted and funded by the ASSMaF (Italian Association for the study of Systemic Sclerosis and Fibrosing Diseases).
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Maddali Bongi, S., Del Rosso, A., Galluccio, F. et al. Efficacy of connective tissue massage and Mc Mennell joint manipulation in the rehabilitative treatment of the hands in systemic sclerosis. Clin Rheumatol 28, 1167–1173 (2009). https://doi.org/10.1007/s10067-009-1216-x
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DOI: https://doi.org/10.1007/s10067-009-1216-x