Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
J Hand Ther. 2023 Oct-Dec;36(4):751-769. doi: 10.1016/j.jht.2023.02.008. Epub 2023 Aug 11.
This was a single-blinded randomized clinical trial.
Systemic sclerosis (SSc) is an autoimmune connective tissue disease that progresses with fibrosis. Patients with SSc need to be protected against epidemic diseases and provided for in terms of rehabilitation needs.
To compare the effects of real-time telerehabilitation (RTT) and asynchronous telerehabilitation (AT) on individuals with SSc.
Forty-two participants with SSc with a mean age of 44.17 ± 11.05 years were included in the study. The patients were randomly divided into three groups, RTT (n = 16), AT (n = 16), and control (n = 16) groups. A structured rehabilitation program was performed in real-time (RTT group) and asynchronously (AT group) for 40 minutes per day, in three sessions per week for 8 weeks. The participants' finger and wrist joint range of motion (ROM), upper extremity functions, grip strength, superficial sense of touch, activities of daily living (ADL), and general health status were assessed at baseline and after treatment.
After 8 weeks, there were improvements in finger ROM (effect size [ES] = 0.23 to 0.60), wrist ROM (ES = 0.45 to 0.83), upper extremity functions (ES = 0.61 to 1.00), and ADL parameters (ES = 0.74) in the RTT group (p < 0.05). Also, there were improvements in finger ROM (ES = 0.16 to 0.45) and hand functions (ES = 0.54 to 0.55) in the AT group (p < 0.05). The RTT and AT groups had better hand functions and finger ROM than the control group in (p < 0.05). In addition, the RTT group had better wrist ROM than the control group (p = 0.008). RTT was superior to AT only in lateral pinch strength (p = 0.025).
Experimental groups achieved a statistically significant change in ROM, upper extremity functions and ADL over time in concordance with prior investigations. Changes in grip strength, superficial sense of touch, and general health status scores differed from previous investigations and the between-group comparison was not statistically significant.
Both RTT and AT may be effective in individuals with SSc, and RTT has additional benefits.
这是一项单盲随机临床试验。
系统性硬化症（SSc）是一种自身免疫性结缔组织疾病，会进展为纤维化。SSc 患者需要预防传染病，并满足康复需求。
比较实时远程康复（RTT）和异步远程康复（AT）对 SSc 患者的影响。
纳入 42 名平均年龄为 44.17±11.05 岁的 SSc 患者。患者被随机分为三组：RTT（n=16）、AT（n=16）和对照组（n=16）。每天进行 40 分钟的结构化康复计划，每周 3 次，持续 8 周。在基线和治疗后评估参与者的手指和腕关节活动度（ROM）、上肢功能、握力、浅感觉、日常生活活动（ADL）和一般健康状况。
8 周后，RTT 组手指 ROM（效应量[ES]为 0.23 至 0.60）、腕关节 ROM（ES 为 0.45 至 0.83）、上肢功能（ES 为 0.61 至 1.00）和 ADL 参数（ES 为 0.74）均有改善（p＜0.05）。此外，AT 组手指 ROM（ES 为 0.16 至 0.45）和手部功能（ES 为 0.54 至 0.55）也有改善（p＜0.05）。与对照组相比，RTT 和 AT 组的手部功能和手指 ROM 更好（p＜0.05）。此外，RTT 组的腕关节 ROM 优于对照组（p=0.008）。仅在侧捏力方面，RTT 优于 AT（p=0.025）。
实验组的 ROM、上肢功能和 ADL 随时间推移均有统计学意义上的显著变化，与既往研究一致。握力、浅感觉和一般健康状况评分的变化与既往研究不同，组间比较无统计学意义。
RTT 和 AT 均可有效治疗 SSc 患者，且 RTT 具有额外益处。
