Neurofascialvascular training in systemic sclerosis: Clinical outcomes, proposed rationale, and home-programme...

Secondary Raynaud's phenomenon in limited cutaneous systemic sclerosis is driven by structural microvascular disease and is frequently accompanied by hand oedema, stiffness, and functional disability. Evidence for pragmatic physiotherapy approaches addressing both vascular symptoms and soft-tissue involvement remains limited.

A 66-year-old man with limited cutaneous systemic sclerosis (diagnosed in 2009) and long-standing triphasic Raynaud's symptoms reported cold-induced digital pain, recurrent fissures with prior ulceration, puffy hands, reduced finger range of motion, and impaired fine motor function despite stable therapy, including intravenous prostacyclin every 2 weeks. Outcomes at baseline (November 2024), post-intervention (April 2025), and follow-up (December 2025) included the Raynaud's Condition Score, QuickDASH, ScleroID, COMPASS-31, and HAMIS.

The patient completed a structured neurofascialvascular training programme comprising 24 supervised 30-minute sessions (November 2024 to April 2025) with home practice on non-clinic days, followed by a home-only programme (30 minutes/day) through follow-up; adherence was monitored with an exercise log.

Symptom burden and hand function improved from baseline to post-intervention and were largely maintained at follow-up, with shorter typical Raynaud's episodes and better hand mobility and disability scores. About 5% of prescribed home sessions were missed. Infrared thermography and clinical photographs were used descriptively to show acute pre-post session thermal changes and longitudinal reductions in puffiness and colour changes; follow-up images were obtained in December (cold season).

This case suggests that a neurofascialvascular training programme was feasible and was associated with sustained improvement in Raynaud-related burden and hand function, warranting prospective controlled evaluation.