Non-pharmacological therapy may benefit hand function in systemic sclerosis
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Key takeaways:
- Patients with systemic sclerosis reported an improved ability to perform daily tasks when receiving non-pharmacological interventions.
- The most common intervention studied was exercise.
Non-pharmacological strategies such as exercise can improve hand function in patients with systemic sclerosis, according to data published in the International Journal of Rheumatic Diseases.
“Research on non-pharmacological interventions to improve hand function and the performance of activities of daily living in SSc has grown in recent years, probably due to advances in science and the relevance for both individuals with SSc and health professionals,” Alba Navas-Otero, a Master’s student at the University of Granada, in Spain, and colleagues wrote. “These articles on non-pharmacological therapies included different therapeutic approaches such as exercise therapies, self-management programs and educational and/or home interventions.”
To investigate the effectiveness of non-pharmacological interventions in the improvement of hand function in patients with SSc, Navas-Otero and colleagues conducted a systematic literature review using databases including the Cochrane Library, Medline, PEDro, OTseeker, Scopus and the Web of Science. The researchers included pertinent randomized controlled trials that were published in English, French or Spanish through Sept. 10, 2022. Papers were excluded from the analysis if they exclusively compared non-pharmacological interventions or were animal studies, systemic reviews, meta-analyses, descriptive studies, books, editorials, letters, conference papers or doctoral theses.
The primary outcome was hand function, while the second outcome of interest was patients’ ability to complete activities associated with daily life. Two reviewers assessed and extracted data from pertinent studies. Following extraction, information was standardized. In cases where published papers did not provide all the information needed to perform an analysis, the original authors were contacted if possible.
The analysis included eight studies, representing a total of 487 patients with SSc. The most common intervention studied in the trials was exercise. According to the researchers, patients who engaged in non-pharmacological interventions for SSc maintained higher hand function vs. patients in the no-treatment control groups, or those on waiting lists for treatments. For hand function, the mean difference (MD) was –6.98 (95% CI, –11.45 to –2.5). For ability to perform daily activities, the MD was –0.19 (95% CI, –0.33 to –0.04).
“The results obtained from this systematic review and meta-analysis have several implications for future research and clinical practice in the rehabilitation area and for understanding the effective evidence-based non-pharmacological interventions available for enhancing the hand function and performance of daily activities in patients with SSc,” Navas-Otero and colleagues wrote. “The majority of studies included hand exercise as part of their intervention protocol. Therefore, further research is necessary on the use of hand exercises in SSc individuals, considering the different types of exercise that exist.”
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