Physical Rehabilitation Interventions for Hand Function in People with Systemic Sclerosis. A Scoping Review

Objectives To synthesize current evidence for physical rehabilitation interventions to improve hand function in people with systemic sclerosis (SSc). Methods Medline and Pubmed were searched to identify studies of rehabilitation interventions for hand function in SSc. Articles were included based on reporting of participants aged 18 years or older with SSc; physical therapy, occupational therapy or rehabilitation interventions; any aspect of hand function as an outcome, and English language. The study was conducted according to the PRISMA Extension for Scoping Reviews. Results Eighteen studies involving 1,205 participants were included. Study designs included 13 randomized controlled trials, 2 pretest-posttest studies, 1 controlled trial, 1 quasi-experimental study, and 1 pilot study. Small sample sizes were common, with 9 studies including fewer than 40 participants. Interventions included combination of manual therapy and prescribed exercises (Table 1); self-administered exercise protocol, virtual treatment platform or telerehabilitation program; paraffin wax; manual lymphatic drainage; and dynamic splinting. Table 1. Hand Stretching/ Range of Motion Exercise Protocols Conclusion Evidence supports supervised exercises and manual therapy to improve hand function in people with SSc. Despite consensus recommendations advocating for physical rehabilitation and hand-stretching as part of standard care in SSc, high-quality research remains limited.