Musculoskeletal Rehabilitation in the Person with Scleroderma

Janet L. Poole


Curr Opin Rheumatol. 2010;22(2):205 

In This Article


Dynamic splints, designed to increase motion in the PIP joint, were investigated in a pretest posttest study by Seeger and Furst[25] with 19 persons with scleroderma (Table 4). One hand wore the splint and the other hand served as the control. The splint schedule was 8 h/day for the 2-month study period. Baseline range of motion measurements were taken and repeated at 1-month and 2-month intervals by an evaluator blind to the study. The splint was a dorsal splint with an outrigger to encourage extension of the PIP joint. Only eight of 19 participants completed the study. Of the 11 dropouts, four experienced iatrogenic splint exacerbated Raynaud's phenomenon, three had worsening of their systemic disease, and four dropped out for reasons unrelated to the disease. Of the eight who completed the study, there was no significant reduction in the flexion contractures over the 2-month period. The splints did not maintain or reduce PIP extension and there was no difference in PIP extension in the splinted and nonsplinted hands. Only one person responded to the splints. This lack of improvement in PIP extension is disappointing, as dynamic splints have been shown to reduce contractures in other conditions.


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