Musculoskeletal Rehabilitation in the Person with Scleroderma

Janet L. Poole

Disclosures

Curr Opin Rheumatol. 2010;22(2):205 

In This Article

Discussion

In the mid 1990s, both the studies by Alpiner et al.[30] and Casale et al.[31] stressed the importance of rehabilitation regimens for scleroderma and recommended stretching, range of motion, heat, massage, and splints to treat the musculoskeletal impairments. Both also pointed out that these interventions have not been well studied. Since that time there has been a marked increase in the number of studies that have evaluated the effectiveness of these rehabilitation techniques. Based on the studies evaluated in this review, it appears that range of motion exercises and connective tissue massage with joint manipulation to the hands do improve joint motion. It is not clear whether there are subsequent improvements in hand function or the ability to use the hands to perform daily tasks. Although there was only one study, splinting did not appear to be effective as participants could not tolerate wearing the splints. Although there are reports of muscle involvement and weakness in people with scleroderma,[1,2,12,27•] the outcomes studied were cardiovascular function, quality of life, and endurance (i.e. walking time), which are more associated with the pulmonary function than musculoskeletal function. Thus, it is not clear whether generalized strengthening and aerobic exercise improve muscle strength or the ability to perform daily tasks.

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