A mixed method study exploring patient satisfaction and feasibility of two exercise programmes in systemic...

Area of Science:

• Rheumatology
• Oral Medicine
• Physical Therapy

Background:

• Scleroderma (SSc) frequently causes facial fibrotic changes and reduced oral aperture, impacting eating and oral hygiene.
• Low adherence to oral exercises limits their effectiveness in increasing oral aperture for SSc patients.

Purpose of the Study:

• To assess the feasibility, patient satisfaction, and effectiveness of two distinct exercise programs for SSc-associated microstomia.

Main Methods:

• A mixed-methods study randomized adult SSc patients with microstomia (<40mm maximal oral aperture) into two groups.
• Group A used a jaw motion device (Therabite), while Group B performed mouth-stretching exercises for 3 months (10 min, 3x/day).
• Evaluations occurred at baseline, 3, 6, and 9 months, with semi-structured interviews at 6 months.

Main Results:

• Both interventions increased maximal oral aperture, with median improvements of 9mm (Therabite) and 7mm (stretching exercises) at 6 months.
• Adherence rates were generally high, ranging from 48.5% to 98.9% across both groups.
• Qualitative interviews identified key drivers, challenges, and perceived benefits of the exercise programs.

Conclusions:

• Both exercise interventions effectively improved maximal oral aperture in SSc patients.
• High adherence was observed, but the prescribed thrice-daily frequency was not considered feasible for long-term practice.
• Further research is necessary to establish sustainable, long-term exercise regimens for SSc-associated microstomia.