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SclerodermaNCT04179292

The Effect of Physiotherapy Program in Scleroderma Patients

A study testing Hand Therapy by Physiotherapist and Hand Therapy as home program in people with Scleroderma and Systemic Sclerosis, run by Istanbul University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study was to investigate the effectiveness of physiotherapy and rehabilitation program on hand involvement of patients with scleroderma and to compare the effects of home rehabilitation program and rehabilitation program under physiotherapist supervision. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Scleroderma, Systemic Sclerosis, Hand Rheumatism
What is being tested?
Hand Therapy by Physiotherapist and Hand Therapy as home program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteTurkey (Türkiye)
Study dates
21 Nov 2019to 27 Jan 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Having been diagnosed with scleroderma
  • Stability of medical treatments
  • To be able to adapt to the exercises

Who cannot join

  • The patient has a history of neurological disease or trauma that may affect his symptoms
  • Systemic involvement that affects the treatment process
  • Being in the active phase of the disease

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Tugba Civi Karaaslan

    Istanbul, Buyukcekmece

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of Physiotherapy Program in Scleroderma Patients: A Randomized Clinical Trial

The aim of this study was to investigate the effectiveness of physiotherapy and rehabilitation program on hand involvement of patients with scleroderma and to compare the effects of home rehabilitation program and rehabilitation program under physiotherapist supervision. At the end of the study, the rehabilitation program under the supervision of physiotherapist and home exercise program will be compared with the effects of these applications on range of motion, grip strength, function and sensation. Since there are a limited number of randomized controlled studies in the literature on this subject and there is no randomized controlled clinical study on the superiority of physiotherapist supervision and home program, it will contribute to the information regarding the rehabilitation of scleroderma patients.

Read the detailed description

Scleroderma is an autoimmune connective tissue disease with fibrosis. Although its etiology and pathogenesis have not been clearly defined, it has a chronic course. It is estimated that scleroderma affects approximately 300,000 people in the United States. Most commonly, it affects adults and women.

When the current literature is examined, Landim et al. in their studies for the development and evaluation of hand exercises home program in patients with systemic scleroderma; They found that the 8-week home exercise program had positive effects on pain, function, mobility and strength. Antonioli et al. concluded that individualized rehabilitation program could improve quality of life and hand mobility in patients with systemic sclerosis. Lopes et al. found that the degree of physical disability was related to both hand grip strength and pulmonary function, but there was no relationship between hand grip strength and pulmonary function in these patients. Mancuso et al. In their case series studies examining the effect of paraffin and exercise on hand functions in scleroderma, they concluded that paraffin and hand exercises can be used to improve hand functions related to participation in daily activities. Rannou et al. in their study comparing the effects of physical therapy program and the usual care of patients with systemic sclerosis on disability, they concluded that 1-month individualized supervised physical therapy program followed by home exercise programs provided short-term benefit. Bongi et al. systemic scleroderma patients with general rehabilitation programs applied to the hand and face specific programs designed to evaluate the effectiveness of their studies; have shown that these techniques improve disability, HRQoL, hand and face functionality.

A limited number of studies in the literature emphasize the need for more research with larger sample size and more variable control.

The aim of this study was to investigate the effectiveness of physiotherapy and rehabilitation program on hand affected patients with scleroderma diagnosis and to compare the effects of home exercise program with physiotherapist supervision. At the end of the study, the rehabilitation program under the supervision of physiotherapist will be compared with the home exercise program and data on the effects of these applications on range of motion, grip strength, function and sensation will be obtained; their superiority to each other will be revealed.

Being tested
Hand Therapy by Physiotherapist, Hand Therapy as home program
Keywords
Scleroderma, Systemic sclerosis, Hand therapy
Medical subject headings
Scleroderma, Diffuse, Scleroderma, Systemic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hand Therapy by PhysiotherapistOther

    Also called Physiotherapy and Rehabilitation

    stretching exercises; all finger joints, wrist and supination-pronation direction strengthening exercises; finger and wrist functional exercises retrograde massage; starting from the distal phalanx to the elbow sensory education; desentilation training (cotton…) breathing exercises 5 days / week, 8 weeks in total

    • 3 days / week with physiotherapist
    • 2 days / week as home program 30 minutes / day 12 repetitions
  • Hand Therapy as home programOther

    Also called Physiotherapy and Rehabilitation

    stretching exercises; all finger joints, wrist and supination-pronation direction strengthening exercises; finger and wrist functional exercises retrograde massage; starting from the distal phalanx to the elbow sensory education; desentilation training (cotton…) breathing exercises 5 days / week, 8 weeks in total

    • 3 days / week with physiotherapist
    • 2 days / week as home program 30 minutes / day 12 repetitions
Study groups in NCT04179292
Study groupRoleWhat they receive
Physiotherapy ProgramExperimentalStretching and strengthening exercises, functional exercises, massage techniques, sensory training and breathing exercises will be applied to the patients by physiotherapist for 3 sessions per week. On the other days, it will be implemented as an 8-week home program with 5 sessions per week.
Receives: Other: Hand Therapy by Physiotherapist
Home ProgramExperimentalStretching and strengthening exercises, functional exercises, massage techniques, sensory training and breathing exercises will be applied to the patients as home program. Motivation will be provided by contacting by phone / call once a week for follow-up.
Receives: Other: Hand Therapy as home program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hand Mobility in Scleroderma (HAMIS)

    Hand Mobility in Scleroderma is a hand function test developed for adults who have systemic sclerosis. HAMIS consists of 9 items designed to measure all movements assessed in an ordinary range of motion-measured hand test. Each item is graded on a 0-3 scale, where 0 corresponds to normal function and 3 denotes that the individual is unable to perform the item. Each hand is assessed separately. The total score of HAMIS for each hand is 370 Sandqvist and Eklund Vol. 13, No. 6, December 2000 27, which represents a high degree of dysfunction.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

Secondary outcomes (6)
  1. 9-Hole Peg Test

    It is used to evaluate patients' hand and finger skills. The pegboard is placed in the middle of the body. It is desirable that 9 wooden pins be placed randomly in the 9-hole wooden block as fast as possible, and then the pins are removed from the wooden block and placed in the storage compartment one by one. These times are measured and recorded with a stopwatch. A total of 20 seconds or more is considered a "loss of skill".

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

  2. Duruöz Hand Index

    The Duruoz Hand Index (DHI) is a self-report questionnaire designed to evaluate activity limitations of the hand. This scale contains 18 items. Every item has a score between 0-5 and total score changes between 0-90. Higher scores indicate severe hand-related disability.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

  3. Scleroderma Health Assessment Questionnaire (SHAQ)

    The Scleroderma Health Assessment Questionnaire is a measurement tool for evaluating function in individuals with systemic scleroderma and has been used in a number of countries. SHAQ is made up of 20 items distributed among eight domains and has five additional domains that assess dysfunctions caused by the symptoms of systemic scleroderma. For this, five visual analogue scales (VASs) are used. The scores on these scales are converted to subscores ranging from 0 to 3 points. The overall score of the questionnaire is the sum of each of the five VAS subscores and the scores for the eight domains, divided by 13. Lower score indicates better health status.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

  4. Semmes Weinstein Monofilaman Test

    The severity of pain and paresthesia symptoms of the patients will be assessed using the 10 cm Visual Analogue Scale. Before the assessment, patients instruct that "0" for "no symptoms", "10" represents "the most severe pain that could be felt" and should mark the point that best describes the symptom. The patient's rest, activity and night pain in the last week will be questioned separately. To evaluate the paresthesia, the most severe paresthesia felt by the patient in the last 1 week will be questioned and it will be asked to mark the place that best expresses paresthesia on the scale. Marked points measure by a ruler and record in centimeters.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

  5. Pittsburgh Sleep Quality Index (PSQI)

    The Pittsburgh Sleep Quality Index is a self-report questionnaire that assesses sleep quality over a 1-month time interval. The measure consists of 19 individual items, creating 7 components that produce one global score. Each item is weighted on a 0-3 interval scale. The global PSQI score is then calculated by totaling the seven component scores, providing an overall score ranging from 0 to 21, where lower scores denote a healthier sleep quality.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

  6. Fatigue Severity Scale (FSS)

    The Fatigue Severity Scale is a 9-item scale which measures the severity of fatigue and its effect on a person's activities and lifestyle in patients with a variety of disorders. Answers are scored on a seven point scale where 1 = strongly disagree and 7 = strongly agree. This means the minimum score possible is nine and the highest is 63. The higher the score, the more severe the fatigue is and the more it affects the person's activities.

    Measured: before treatment, at 8 weeks, 16 weeks, and 12 months change

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Nov 2019
  2. Study start21 Nov 2019
  3. Primary completion21 Nov 2020
  4. Study completion27 Jan 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized Clinical Study
Masking
None (open label)
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04179292
Sponsor's protocol ID
IstanbulU2
Status last verified
Jan 2021
First submitted
6 Nov 2019
Last updated
28 Jan 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Distler O, Cozzio A. Systemic sclerosis and localized scleroderma--current concepts and novel targets for therapy. Semin Immunopathol. 2016 Jan;38(1):87-95. doi: 10.1007/s00281-015-0551-z. Epub 2015 Nov 17.

    PubMed 26577237
  • Vehe RK, Riskalla MM. Collagen Vascular Diseases: SLE, Dermatomyositis, Scleroderma, and MCTD. Pediatr Rev. 2018 Oct;39(10):501-515. doi: 10.1542/pir.2017-0262. No abstract available.

    PubMed 30275033
  • Landim SF, Bertolo MB, Marcatto de Abreu MF, Del Rio AP, Mazon CC, Marques-Neto JF, Poole JL, de Paiva Magalhaes E. The evaluation of a home-based program for hands in patients with systemic sclerosis. J Hand Ther. 2019 Jul-Sep;32(3):313-321. doi: 10.1016/j.jht.2017.10.013. Epub 2017 Dec 1.

    PubMed 29198478
  • Antonioli CM, Bua G, Frige A, Prandini K, Radici S, Scarsi M, Danieli E, Malvicini A, Airo P. An individualized rehabilitation program in patients with systemic sclerosis may improve quality of life and hand mobility. Clin Rheumatol. 2009 Feb;28(2):159-65. doi: 10.1007/s10067-008-1006-x. Epub 2008 Sep 16.

    PubMed 18795394
  • Lopes AJ, Justo AC, Ferreira AS, Guimaraes FS. Systemic sclerosis: Association between physical function, handgrip strength and pulmonary function. J Bodyw Mov Ther. 2017 Oct;21(4):972-977. doi: 10.1016/j.jbmt.2017.03.018. Epub 2017 Mar 29.

    PubMed 29037654
  • Mancuso T, Poole JL. The effect of paraffin and exercise on hand function in persons with scleroderma: a series of single case studies. J Hand Ther. 2009 Jan-Mar;22(1):71-7; quiz 78. doi: 10.1016/j.jht.2008.06.009. Epub 2008 Aug 30.

    PubMed 18950987
  • Rannou F, Boutron I, Mouthon L, Sanchez K, Tiffreau V, Hachulla E, Thoumie P, Cabane J, Chatelus E, Sibilia J, Roren A, Berezne A, Baron G, Porcher R, Guillevin L, Ravaud P, Poiraudeau S. Personalized Physical Therapy Versus Usual Care for Patients With Systemic Sclerosis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2017 Jul;69(7):1050-1059. doi: 10.1002/acr.23098. Epub 2017 Jun 7.

    PubMed 27696703
  • Schapira AH, Holt IJ, Sweeney M, Harding AE, Jenner P, Marsden CD. Mitochondrial DNA analysis in Parkinson's disease. Mov Disord. 1990;5(4):294-7. doi: 10.1002/mds.870050406.

    PubMed 1979656

Questions about this trial

What is this clinical trial studying?

A study testing Hand Therapy by Physiotherapist and Hand Therapy as home program in people with Scleroderma and Systemic Sclerosis, run by Istanbul University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hand Mobility in Scleroderma (HAMIS) (time frame: before treatment, at 8 weeks, 16 weeks, and 12 months change). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04179292, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2021.

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