Effects of a 12-week physiotherapist-supervised home-based rehabilitation program on the functional exercise capacity in people with systemic sclerosis

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 (r_s = −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.