In-person occupational therapy, app-delivered exercises confer benefits for hand disability

For systemic sclerosis (SSc) patients, occupational therapy and/or performing exercises delivered via a mobile application can help reduce hand disability, as shown in a recent study.

A total of 32 patients with diffuse cutaneous SSc were randomized to one of two 18-week interventions: (1) intensive occupational therapy, which involved 8-weekly in-person therapy sessions, with app-delivered home exercises or (2) app-delivered home exercises only.

The mean age of the patients was 52 years, and most of them were women (72 percent). The primary outcome measure of QuickDASH hand disability at week 18 did not differ between the two intervention groups (mean change, –6.4 on a 0–100 scale in both intensive and app-alone groups; p=1.0).

Interestingly, the exploratory outcome of left lateral pinch showed greater improvement in the app-alone than in the intensive group at 18 weeks.

The intensive group achieved the largest improvements in QuickDASH after 8 weeks (mean change, –8.5; p=0.03), but lost gains from weeks 8 to 18. In comparison, the app-alone group had modest improvements from baseline to 8 weeks and continued to improve through week 18.

Of the patients who completed the intervention, 50 percent in the intensive group had clinically meaningful improvement in QuickDASH as compared with 64 percent in the app-alone group.

The present data provide support for further study into telehealth rehabilitation approaches in the treatment of SSc.