Self-management programs for hands in systemic sclerosis - literature review/ Programas de autogestão das mãos na esclerose sistémica - revisão de literatura

Introduction: Self-management programs are interesting strategies to prevent or reduce hand commitment in Systemic Sclerosis (SSc). Objective: Describe the current research on self-management hand care program for patients with SSc. Methods: We conducted a systematic literature review focusing on self-management programs for SSc. Results: The MEDLINE search allowed the identification of 13 papers, after applying the exclusion criteria, 8 papers was selected for our analyses. Conclusion: Although the small number of studies, there are promising data regarding the benefits of self-management programs for hands in SSc

"Hands on" a hand care guide in systemic sclerosis

Orientador: Manoel Barros BértoloDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Objetivo: Avaliar o efeito de um programa de autogestão domiciliar para as mãos em pacientes com Esclerose Sistêmica (ES). Métodos: Utilizou-se um guia de orientações e exercícios para as mãos em pacientes com ES durante oito semanas. Os indivíduos preencheram uma ficha de avaliação referente aos dados sóciodemográficos (idade, renda, escolaridade), clinica (duração da doença, tipo de ES limitado ou difuso, escore cutâneo modificado de Rodnan - ECRM), dor nas mãos (Escala Visual Analógica de Dor - EVA), Função das mãos (Cochin), doença (SHAQ), amplitude de movimento (d-FTP), força de preensão e força de pinça, impacto do Fenômeno de Raynaud (FRy) e Úlcera Digital (UD). As impressões dos pacientes sobre o programa também foram avaliadas. Resultados: 22 pacientes com ES (19 mulheres; 3 homens; 16 limitadas: 6 difusas) completaram o programa com melhora de função manual (Cochin), doença (SHAQ), amplitude de movimento (d-FTP), dor e redução do impacto Fry. Os pacientes melhoraram seus hábitos de hidratação e prevenção ao frio. Os pacientes consideraram o programa fácil de compreender sem efeitos adversos relacionados aos exercícios. As melhorias foram independentes da idade, renda, escolaridade, duração da doença, tipo de ES. Conclusão: Este programa domiciliar para pacientes com ES melhorou a função, mobilidade, força e dor dos pacientes avaliados após 8 semanasAbstract: Objective: To evaluate the effect of a home based self-management program on the hands of patients with systemic sclerosis (SSc). Methods: A hand care guide with hand exercises was applied in a group of patients with SSc during eight weeks. Subjects were accessed regarding social demographic data (age, income, education), disease (duration, subtype ¿ limited or diffuse, modified Rodnan Skin Score ¿ MRSS), hand pain (Visual Analogue Scale - VAS), Cochin Hand Function Scale (CHFS), Scleroderma Health Assessment Questionnaire (S-HAQ), delta finger to palm (d-FTP), grip strength and pinch strength, Raynaud Phenomena (RyP) and Digital Ulcers (DU) impact. Subjects¿ impressions about the program were also assessed. Results: 22 SSc subjects (19 women; 3 men; 16 limited; 6 diffuse) completed the program with hand function (CHFS), disability (S-HAQ), claw deformity (d-FTP), grip and pinch strength (p<0.05), pain and RyP impact reduction. Subjects improved their moisturizing and cold avoidance habits. Subjects considered the program easy to follow with no adverse effects related to exercises. Improvements were independent of age, income, education, disease duration, subtype, MRSS). Conclusion: This home based program for patients with SSc improved function, mobility and strength and reduced pain after 8 weeks. Patient adherence and sustained efficacy during a longer period is still to be determinedClinica MedicaMestra em Clínica Médica02P-1736-2016CAPE