一项自我管理远程医疗计划对改善系统性硬化症患者力量和手部功能的影响：一项随机对照试验。
Effects of a Self-Management Telehealth Program on Improving Strength and Hand Function in Systemic Sclerosis Patients: A Randomized Controlled Trial.
作者信息
Wantha Orathai, Mahakkanukrauh Ajanee, Suwannaroj Siraphop, Tuydaung Kwankaew, Methakanjanasak Nonglak, Srichomphu Kannika, Kraipoj Jinnaphat, Foocharoen Chingching
机构信息
Division of Nursing, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
出版信息
Life (Basel). 2025 Jul 10;15(7):1087. doi: 10.3390/life15071087.
OBJECTIVE
A self-management telehealth program to improve hand strength and function in systemic sclerosis (SSc) patients may improve their quality of life, so we investigated its efficacy.
METHODS
A 6-week prospective randomized controlled study was conducted in adults with SSc with a hand mobility in scleroderma (HAMIS) score > 1 or a limited range of motion in at least one hand joint. Participants were randomly allocated into three groups for six weeks of health education: (a) typical education, (b) watching video guides as needed, in addition to typical education, and (c) watching video guides and receiving weekly telephone notifications, in addition to typical education. The endpoints were the differences in self-management behavior, HAMIS scores, hand grip strength (HGS), and quality of life (QoL) using the European Quality of Life-5 Dimensions between groups, as well as the changes in these parameters compared to baseline.
RESULTS
A total of 24 patients per group were enrolled, with the majority diagnosed with diffuse cutaneous SSc (79.2%). Six weeks post-intervention, HGS improved significantly in both the video guide and telephone notification groups compared to typical education in both hands ( = 0.028, = 0.044). Pincer grip differed between the groups in the non-dominant hand. Household modifications were more frequent in the video guide and telephone notification groups than in the typical education group ( = 0.023). All groups showed significant improvements in HGS and HAMIS scores in both hands, as well as in self-management behaviors, compared to baseline. QoL, as measured using a visual analog scale, improved significantly after the intervention in both the video guide and telephone notification groups, but not in the typical education group.
CONCLUSIONS
Self-management telehealth programs effectively enhance hand strength, function, and self-management behaviors in patients with SSc with limited hand function. Weekly telephone notifications further reinforced continuity and engagement in these patients.
目的
一项旨在改善系统性硬化症（SSc）患者手部力量和功能的自我管理远程医疗项目可能会提高他们的生活质量，因此我们对其疗效进行了调查。
方法
对成人系统性硬化症患者开展了一项为期6周的前瞻性随机对照研究，这些患者的硬皮病手部活动度（HAMIS）评分>1或至少一个手部关节活动范围受限。参与者被随机分为三组，接受为期六周的健康教育：（a）典型教育，（b）除典型教育外，按需观看视频指南，（c）除典型教育外，观看视频指南并每周接收电话通知。终点指标为三组之间自我管理行为、HAMIS评分、握力（HGS）以及使用欧洲五维健康量表（EQ-5D）评估的生活质量（QoL）的差异，以及这些参数与基线相比的变化。
结果
每组共纳入24例患者，大多数患者被诊断为弥漫性皮肤型SSc（79.2%）。干预六周后，与典型教育组相比，视频指南组和电话通知组双手的HGS均有显著改善（右手P = 0.028，左手P = 0.044）。非优势手的捏力在各组之间存在差异。视频指南组和电话通知组比典型教育组更频繁地进行家居改造（P = 0.023）。与基线相比，所有组双手的HGS和HAMIS评分以及自我管理行为均有显著改善。使用视觉模拟量表测量的QoL在视频指南组和电话通知组干预后有显著改善，但在典型教育组中没有。
结论
自我管理远程医疗项目有效地增强了手部功能受限的SSc患者的手部力量、功能和自我管理行为。每周的电话通知进一步加强了这些患者的连续性和参与度。
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