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29 IMPROVEMENT OF HAND FUNCTION IN SCLERODERMA WITH CONTINUOUS PASSIVE MOTION
  1. S. Hayat1,
  2. Click P. Fenter1,
  3. C. Salisbery1,
  4. R. Wolf1
  1. 1Center of Excellence - Arthritis and Rheumatology and Department of Physical and Occupational Therapy, Shreveport

Abstract

Introduction Maintenance of hand function is vital to the management of scleroderma if individuals are to remain independent. With progressive loss of range of motion in the wrist and hands attenuation of this change may provide individuals with decreases in functional loss.

Purpose This single subject research design was employed to determine the effect of continuous passive motion (CPM) on hand range of motion.

Methods A 45 year old African American male with scleroderma diffuse disease, with a total skin score of 22. Patient was on methotrexate 7.5 mg once a week, folic acid 1 mg once a day and prednisone 10 mg once a day. He was treated by a licensed occupational therapist for baseline evaluation of active and passive range of motion of the wrist and hands and administration of Arthritis Hand Function Test.(AHFT). The patient was instructed in a daily home exercise program consisting of active and passive range of motion of wrist and all digits and was instructed to use continuous passive motion machine on the right hand and a resting hand splint on the left. For equal amounts of time at night for 15 weeks.

Results There was no change in the skin scores. There was improvement in components of AHFT, coins and pegboard unilaterally and safety pins bilaterally. There was no change in grip with CPM. There was significant improvement in right wrist flexion, extension and palmar abduction with CPM. There was no significant improvement on right active and passive range of motion of the MCP, PIP, DIP with CPM.

Conclusion There was improvement in hand function with continuous passive motion. There was no change in skin scores.

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