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Effect of a tailored home-based exercise program in patients with systemic sclerosis: A randomized controlled trial
Mirko Filippetti1,2, Lucia Cazzoletti3, Francesco Zamboni1
1Unit of Respiratory Disease and Sports Medicine, Department of Medicine, University of Verona, Verona, Italy.
Summary
A home-based exercise program significantly improved functional capacity, quality of life, and reduced disability in patients with systemic sclerosis (SSc). This minimally supervised intervention offers a valuable approach for managing SSc symptoms and enhancing patient well-being.
Area of Science:
- Rheumatology
- Rehabilitation Medicine
- Clinical Exercise Physiology
Background:
- Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis, vascular abnormalities, and immune system dysfunction.
- Patients with SSc often experience significant limitations in functional capacity, reduced health-related quality of life (HRQoL), and increased disability.
- Current management strategies for SSc may not fully address the physical deconditioning and functional decline associated with the disease.
Purpose of the Study:
- To evaluate the efficacy of a home-based, minimally supervised exercise program in improving functional capacity, HRQoL, and disability in patients with SSc.
- To compare the outcomes of the home-based exercise program against usual care in an SSc patient cohort.
- To assess the impact of the intervention on specific measures of physical performance and patient-reported outcomes.
Main Methods:
- A 6-month randomized controlled trial involving patients with SSc.
- Intervention group: minimally supervised home-based exercise program (stationary cycling, upper limb strengthening, hand stretching).
- Control group: usual care. Outcome measures included the 6-minute walk test, hand mobility, maximal exercise testing, strength assessments, SF-36 for HRQoL, and HAQ-DI for disability.
Main Results:
- The exercise group showed a significant increase in 6-minute walk distance (+46m) compared to a decrease in the control group (-5m) (P < .001).
- Significant improvements were observed in handgrip strength (P = .003), quadriceps strength (P < .001), biceps strength (P < .001), SF-36 physical component score (P < .001), and HAQ-DI (P = .011).
- Forty-four patients completed the study, with 22 in the intervention group and 22 in the control group.
Conclusions:
- A minimally supervised home-based exercise program is effective in improving physical performance in patients with SSc.
- The intervention positively impacts health-related quality of life and reduces disability in individuals with systemic sclerosis.
- Home-based exercise represents a viable and beneficial therapeutic strategy for managing SSc.
