Investigation of the effect of upper extremity home exercises on grip stength, joint range of motion, activity performance and functionality in individuals with scleroderma

Objective: The aim of the study is to examine the effects of upper extremity home exercises on grip strength, joint range of motion, activity performance and functionality in individuals with scleroderma and comparing it with patient education. Method: Fourty-six individuals with scleroderma (42 female, 4 male) with an average age of 55.52±11.54 years were included in the study. Individuals were randomly divided into the intervention group (n=23) and the control group (n=23). Intervention group received upper extremity home exercise 5 days a week for 8 weeks. Control group received patient education program. Dinamometer and pinchmeter was used to evaluate hand grip and pinch strength. Goniometric measurement was used to evaluate upper extremity joint range of motion (ROM). Canadian Occupational Performance Measure (COPM) was used to evaluate activity performance and satisfaction. Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Score for Assessment and Quantification of Chronic Rheumatic Affections of the Hands (SACRAH), and Duruöz Hand Index (DHI) was used to evaluate functionality. All evaluations were performed at baseline and at the end of the 8th week. Results: Before treatment, the groups were similar except for shoulder external rotation, forearm pronation, fingers passive total ROM and COPM (p>0,05). After treatment, hand grip and pinch strength, shoulder flexion, extention, abduction and rotation, wrist flexion, extention and deviation, total finger ROM, DASH, SACRAH total and subparameters and DHI were significant in favor of the intervention group (p<0,05). Conclusion: Upper extremity home exercises have possitive effects on grip strength, ROM, activity performance and functionality in individuals with scleroderma. Therefore, we suggest that rehabilitation programs should include not only hand exercises but also upper extremity exercises.