Format

Send to

Choose Destination
Arthritis Care Res (Hoboken). 2017 Jul;69(7):1050-1059. doi: 10.1002/acr.23098. Epub 2017 Jun 7.

Personalized Physical Therapy Versus Usual Care for Patients With Systemic Sclerosis: A Randomized Controlled Trial.

Author information

1
AP-HP Cochin Hospital, Université Paris Descartes Sorbonne Paris Cité, and INSERM U1153, Paris, France.
2
AP-HP Hôtel Dieu Hospital, Université Paris Descartes Sorbonne Paris Cité, and INSERM U1153, Paris, France.
3
Reference Center for Rare Diseases, AP-HP Cochin Hospital, and Université Paris Descartes Sorbonne Paris Cité, Paris, France.
4
Reference Center for Rare Diseases, Lille University Medical Center, University of Lille 2, Lille, France.
5
AP-HP Rothschild Hospital and Pierre and Marie Curie University, Paris, France.
6
AP-HP Saint-Antoine Hospital and Pierre and Marie Curie University, Paris, France.
7
Hôpital Hautepierre, Fédération de Médecine Translationnelle de Strasbourg, UMR INSERM 1109, Université de Strasbourg-Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Abstract

OBJECTIVE:

To compare a physical therapy program to usual care of systemic sclerosis (SSc) patients on disability.

METHODS:

A 12-month followup, parallel-group randomized controlled trial involving a modified Zelen design was conducted in 4 tertiary-care hospitals. Patients were enrolled if they had a disability rating ≥0.5 on the Health Assessment Questionnaire disability index (HAQ DI) or symptoms of decreased mouth opening or limited range of motion of at least 1 joint. The experimental intervention (n = 112, of which 110 were analyzed) was a 1-month personalized supervised physical therapy program provided by trained care providers followed by home sessions. The comparator (n = 108, and all 108 were analyzed) was usual care that could include ambulatory physical therapy. The primary outcome was the HAQ DI score.

RESULTS:

There was no statistically significant difference in disability at 12 months (HAQ DI score between-group difference -0.01 [95% confidence interval (95% CI) -0.15, 0.13]; P = 0.86). Disability was reduced at 1 month for patients in the physical therapy group (HAQ DI between-group difference -0.14 [95% CI -0.24, -0.03]; P = 0.01); at 6 months the HAQ DI score between-group difference was -0.12 (95% CI -0.23, 0.01); P = 0.054. There was a statistically significant difference for hand mobility and function, and for pain, at 1 month. Microstomia was lower in the physical therapy group at 1, 6, and 12 months (between-group difference at 12 months 1.62 [95% CI 0.32, 2.93]; P = 0.01). No differences in adverse effects were observed.

CONCLUSION:

A personalized physical therapy program did not reduce disability at 12 months but had short-term benefits for patients with SSc.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00318188.

PMID:
27696703
DOI:
10.1002/acr.23098
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center