Daily activities and hand function in women with scleroderma

Area of Science:

• Rheumatology
• Occupational Therapy
• Rehabilitation Medicine

Background:

• Systemic sclerosis (scleroderma) is a chronic autoimmune disease characterized by fibrosis, vascular abnormalities, and immune system dysfunction.
• Hand involvement is common in systemic sclerosis, leading to significant morbidity and functional limitations.
• Understanding the impact of hand function on daily activities is crucial for effective patient management.

Purpose of the Study:

• To comprehensively assess hand function and activities of daily living (ADL) in patients with systemic sclerosis.
• To identify factors contributing to ADL difficulties in this population.
• To evaluate the effectiveness of assistive devices and alternative methods in improving ADL.

Main Methods:

• A cohort of 30 patients with scleroderma completed a self-administered ADL questionnaire.
• Hand function was evaluated through measures of hand mobility, dexterity, and grip force.
• Patient-reported symptoms (e.g., Raynaud's phenomenon) and skin thickness (modified Rodnan skin score) were recorded.

Main Results:

• Impairments in finger flexion/extension, reduced dexterity (68-80%), and decreased grip force (46-65%) were observed compared to healthy individuals.
• Raynaud's phenomenon was the most reported symptom, while pitting scars/ulcers were least problematic.
• Difficulties were greater in activities requiring hand/arm function versus lower limb function; Raynaud's, stiffness, grip force, and dexterity strongly correlated with ADL challenges.

Conclusions:

• Impaired hand function is directly linked to difficulties in performing daily activities for individuals with systemic sclerosis.
• The use of assistive devices and alternative working methods significantly enhances ADL performance.
• Interventions focused on improving hand function and the adoption of ergonomic tools are essential for managing systemic sclerosis patients.