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The Efficacy of Self-Administered Stretching for Finger Joint Motion in Japanese Patients with Systemic Sclerosis
NAOKI MUGII, MINORU HASEGAWA, TAKASHI MATSUSHITA, MIKI KONDO, HIDEMITSU ORITO, KOICHI YANABA, KAZUHIRO KOMURA, IKUKO HAYAKAWA, YASUHITO HAMAGUCHI, MUNEHIRO IKUTA, KATSUHIKO TACHINO, MANABU FUJIMOTO, KAZUHIKO TAKEHARA, and SHINICHI SATO ABSTRACT. Objective. To determine the efficacy of self-administered stretching of each finger in Japanese patients with systemic sclerosis (SSc). Methods. Forty-five patients with SSc (32 with diffuse cutaneous SSc and 13 with limited cutaneous SSc) were given instructions on self-administered stretching and were directed to perform it every day. Individual fingers were maintained in a stretched position using the opposite hand for 10 seconds and this was repeated 3–10 times. To evaluate the effect of the stretching program, finger passive range of motion (ROM) was assessed using a goniometer on the first visit and after 1 month and 1 year of the stretching program. The Health Assessment Questionnaire (HAQ) was also assessed on the first visit and 1 year afterward. Results. The total passive ROM was significantly improved in each finger after 1 month of finger stretching. The total passive ROM was further improved or maintained within 1 year after the first visit. Although ROM was less in patients with diffuse cutaneous SSc than in those with limited cutaneous SSc at the first visit, ROM increased significantly irrespective of disease duration or severity of skin sclerosis. Finger stretching may improve the finger function, since the HAQ score for hand functions such as eating and gripping was significantly decreased. Conclusion. Our original self-administered stretching program may be useful for improving finger joint motion in patients with SSc; future studies in various ethnic populations will be needed to determine the universal efficacy of this method. (J Rheumatol 2006;33:1586–92) Key Indexing Terms:
SYSTEMIC SCLEROSIS From Kanazawa University Hospital; Department of Dermatology and Division of Rehabilitation Science, Kanazawa University Graduate School of Medical Science, Ishikawa; and Department of Dermatology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. Supported by project research for systemic sclerosis from the Japanese Ministry of Health and Welfare. N. Mugii, OTR, Kanazawa University Hospital; M. Hasegawa, MD, PhD, Assistant Professor; T. Matsushita, MD, PhD; M. Kondo, MD, PhD; H. Orito, MD; K. Yanaba, MD, PhD; K. Komura, MD, PhD; I. Hayakawa, MD, PhD; Y. Hamaguchi, MD, PhD; M. Fujimoto, MD, PhD, Associate Professor; K. Takehara, MD, PhD, Professor and Chairman, Department of Dermatology, Kanazawa University Graduate School of Medical Science; M. Ikuta, PhD, OTR, Professor; K. Tachino, MD, PhD, Professor, Division of Rehabilitation Science, Kanazawa University Graduate School of Medical Science; S. Sato, MD, PhD, Professor and Chairman, Department of Dermatology, Nagasaki University Graduate School of Biomedical Science. Address reprint requests to Dr. M. Hasegawa, Department of Dermatology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan. E-mail: minoruha@derma.m.kanazawa-u.ac.jp Accepted for publication March 21, 2006.
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