title: Telemedicine applied to kinesiotherapy for hand dysfunction in patients with systemic sclerosis and rheumatoid arthritis: recovery of movement and telemonitoring technology.
abstract: OBJECTIVE
  To describe a feasibility study focused on a telemonitoring approach to self-managed kinesiotherapy sessions for the rehabilitation of hand function in patients with systemic sclerosis (SSc) and rheumatoid arthritis (RA).
  
  
  METHODS
  Ten patients with SSc and 10 with RA were enrolled in a 3-month controlled trial (approval no. 9751/2012 - Italian Department of Health) to perform a home kinesiotherapy protocol, consisting of strengthening and mobility exercises, using a newly developed telemedicine system (a portable device and the related telemonitoring infrastructure). A further 10 patients with SSc and 10 with RA were enrolled as controls to perform a similar home kinesiotherapy protocol with the aid of common daily-life objects. Both groups were evaluated at baseline and at followup, after 6 and 12 weeks. The primary outcome of the trial was hand function measured by Dreiser's index (Functional Index for Hand OA, FIHOA), Health Assessment Questionnaire (HAQ), and the Hand Mobility in Scleroderma (HAMIS) test (only for SSc).
  
  
  RESULTS
  Patients with SSc showed an improvement of FIHOA in both arms (p < 0.01) but the HAQ (p = 0.016) and the HAMIS test (right hand p = 0.016, left hand p = 0.075) improved significantly only in the experimental arm. Patients with RA showed a statistically significant improvement of FIHOA (p = 0.013) and HAQ (p = 0.015) in the experimental arm, while patients in the control arm did not significantly improve. However, no statistically significant differences in outcome measures between treatment methods were observed. Withdrawals were higher in control arms (SSc 20%; RA 30%) than in experimental arms (SSc 10%; RA 10%).
  
  
  CONCLUSIONS
  Telemonitoring of self-administered kinesiotherapy programs is a promising approach to the rehabilitation of hand functions in patients with rheumatic disease.
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari. matteopiga@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Piga
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Iosto
authors.initials: I
authors.lastname: Tradori
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Danilo
authors.initials: D
authors.lastname: Pani
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Barabino
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Alessia
authors.initials: A
authors.lastname: Dessì
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Luigi
authors.initials: L
authors.lastname: Raffo
authors.affiliation: From the Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy.M. Piga, MD, Assistant Professor, Chair of Rheumatology; I. Tradori, PhD, Research Fellow, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari; D. Pani, PhD, Assistant Professor; G. Barabino, Research Fellow; A. Dessì, PhD Candidate; L. Raffo, PhD, Professor, Department of Electrical and Electronic Engineering, University of Cagliari; A. Mathieu, MD, Professor, Rheumatology Unit, Department of Medical Sciences, AOU University Clinic of Cagliari.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mathieu
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D012595:Scleroderma, Systemic / Q000503:physiopathology / Q000534:rehabilitation*; D017216:Telemedicine; D016896:Treatment Outcome
keywords: ADAPTED PHYSICAL THERAPY; HAND DYSFUNCTION; REHABILITATION; RHEUMATOID ARTHRITIS; SYSTEMIC SCLEROSIS; TELEMEDICINE