title: Efficacy of connective tissue massage and Mc Mennell joint manipulation in the rehabilitative treatment of the hands in systemic sclerosis.
abstract: Rehabilitation may contribute to the management of systemic sclerosis (SSc) dealing with disabilities due to hand involvement. The aim of this study is to evaluate the efficacy of a rehabilitation programme based on the combination of connective tissue massage and Mc Mennell joint manipulation specifically conceived for SSc patients' hands. Forty SSc patients were enrolled: 20 (interventional group) were treated for a 9-week period (twice a week, 1 h per session) with a combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme, and 20 (control group) were assigned only to home exercise programme. Patients of both groups were assessed at baseline (T0), after 9 week (T1) and at a 9 weeks follow-up (T2). They were evaluated for quality of life by SF-36 and Health Assessment Questionnaire (HAQ), hands involvement by Hand Mobility in Scleroderma (HAMIS) test, Cochin hand functional disability scale and the measurements of ROM. In the interventional group, fist closure, HAMIS test and Cochin hand functional disability scale improved at the end of the treatment (p < 0.0001) as well as HAQ, Physical Synthetic Index (PSI) and Mental Synthetic Index (MSI) of SF-36 scores (HAQ and PSI, p < 0.0001; MSI, p < 0.001). In the control group, the programme of home daily exercises improved only fist closure at the end of the treatment (p < 0.0001). The combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme is effective in the rehabilitative treatment of SSc hands. This combined treatment may lead to an improvement of hand function and quality of life.
authors: Department of Biomedicine, Division of Rheumatology, AOUC, Denothe Centre, University of Florence, Florence, Italy.
authors: Susanna Maddali
authors: SM
authors: Bongi
authors: Angela
authors: A
authors: Del Rosso
authors: Felice
authors: F
authors: Galluccio
authors: Fabrizio
authors: F
authors: Sigismondi
authors: Irene
authors: I
authors: Miniati
authors: M Letizia
authors: ML
authors: Conforti
authors: Francesca
authors: F
authors: Nacci
authors: Marco Matucci
authors: MM
authors: Cerinic
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000503:physiopathology* / Q000534:rehabilitation*; D016896:Treatment Outcome