Tüfekçi Orkun, Ünal Edibe, Aktaş Batuhan E, Tan Aziz A, Hartuç Çevik İrem, Karabulut Erdem, Pınar Aslı, Korkusuz Feza, Onur Mehmet R, Kiraz Sedat, Akdoğan Ali
Department of Physiotherapy and Rehabilitation, Hacettepe University Institute of Health Sciences, Ankara, Turkey.
Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
Rheumatology (Oxford). 2025 Apr 1;64(4):1940-1948. doi: 10.1093/rheumatology/keae365.
This study aimed to investigation of the effects of the Cognitive Exercise Therapy Approach [Bilişsel Egzersiz Terapi Yaklaşımı (BETY)], a supervised biopsychosocial model-based exercise intervention, on functionality, muscle strength, vascularization, anti-inflammatory and biopsychosocial status in SSc patients.
Thirty-seven SSc patients were included. Twenty of them were recruited into the study group (SG) undergoing BETY group exercise sessions three times a week for 3 months and seventeen were in the control group (CG) following a home exercise program. Assessment tools were the Modified Rodnan Skin Score (mRSS), Scleroderma HAQ (SHAQ), Modified Hand Mobility in Scleroderma (mHAMIS), Duruoz Hand Index (DHI), Six-Min Walk Test (6-MWT), skeletal muscle strength measurements using an isokinetic dynamometer (Biodex System 3 Pro), Shear Wave Elastography, ELISA kits (for tumour necrosis factor-alpha, Interleukin-6, IL-10, serum irisin level), BETY-Biopsychosocial Questionnaire (BETY-BQ), Hospital Anxiety and Depression Scale (HADS) and Short Form-36 (SF-36).
The SG demonstrated improvements in SHAQ, mHAMIS, 6-MWT, BETY-BQ, HADS and SF-36 values, excluding the DHI scores (P < 0.05). In contrast, CG showed worsening in SHAQ-general scleroderma symptoms and HADS scores compared with SG (P < 0.05). IL-10 and TNF-alpha increased in both groups, also various vascular parameters were significantly different changed in SG than CG (P < 0.05). Muscle strength values improved in the SG but decreased in the CG, however, this was statistically not significant (P > 0.05).
BETY can be recommended as a non-pharmacological approach to the disease management of SSc patients.
本研究旨在调查基于监督的生物心理社会模型的运动干预——认知运动疗法方法[Bilişsel Egzersiz Terapi Yaklaşımı (BETY)]对系统性硬化症（SSc）患者的功能、肌肉力量、血管形成、抗炎及生物心理社会状态的影响。
纳入37例SSc患者。其中20例被招募进入研究组（SG），每周进行3次BETY组运动训练，持续3个月；17例进入对照组（CG），遵循家庭运动计划。评估工具包括改良Rodnan皮肤评分（mRSS）、硬皮病健康评估问卷（SHAQ）、硬皮病改良手部活动度（mHAMIS）、Duruoz手部指数（DHI）、六分钟步行试验（6-MWT）、使用等速测力计（Biodex System 3 Pro）测量骨骼肌力量、剪切波弹性成像、酶联免疫吸附测定试剂盒（用于检测肿瘤坏死因子-α、白细胞介素-6、IL-10、血清鸢尾素水平）、BETY-生物心理社会问卷（BETY-BQ）、医院焦虑抑郁量表（HADS）和简明健康调查问卷（SF-36）。
研究组在SHAQ、mHAMIS、6-MWT、BETY-BQ、HADS和SF-36值方面有改善，但DHI评分除外（P < 0.05）。相比之下，与研究组相比，对照组的SHAQ-一般硬皮病症状和HADS评分恶化（P < 0.05）。两组的IL-10和TNF-α均升高，研究组的各种血管参数变化与对照组相比有显著差异（P < 0.05）。研究组的肌肉力量值有所改善，而对照组则下降，但这在统计学上不显著（P > 0.05）。
BETY可作为SSc患者疾病管理的非药物方法被推荐。
