期刊
INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
卷 26, 期 6, 页码 1029-1040出版社
WILEY
DOI: 10.1111/1756-185X.14721
关键词
activity; function; hand; scleroderma; systemic sclerosis
类别
This systematic review suggests that non-pharmacological interventions can improve hand function and performance of daily activities in individuals with systemic sclerosis. A meta-analysis of 8 studies showed that non-pharmacological interventions had better effects compared to waiting list or no treatment control conditions, but there was a moderate risk of bias.
BackgroundSystemic sclerosis (SSc) is an autoimmune rheumatic disease. Individuals with a diagnosis of SSc describe repercussions on their activities of daily living and instrumental activities of daily living that affect their everyday functional capacity. The objective of this systematic review was to explore the effectiveness of non-pharmacological interventions to improve hand function and the ability to perform activities of daily living. MethodsA systematic review was conducted on the Cochrane Library, Medline/PubMed, OTseeker, PEDro, Scopus, Web of Science up to September 10, 2022. Inclusion criteria were defined following PICOS recommendations (Populations, Intervention, Comparison and Outcome measures). Methodological quality was assessed with the Downs and Black Scale and risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A meta-analysis of each outcome was performed. ResultsA total of 8 studies met the inclusion criteria, providing data on 487 individuals with SSc. The non-pharmacological intervention applied the most was exercise. The effects of non-pharmacological interventions were better than those of the waiting list or no treatment control conditions in both outcomes - hand function (mean difference [MD] = -6.98; 95% CI [-11.45, - 2.50], P = 0.002, I-2 = 0%) and performance of daily activities (MD = -0.19; 95% CI [-0.33, - 0.04], P = 0.01, I-2 = 0%). Moderate risk of bias was found in the majority of the studies included. ConclusionThere is emerging evidence that non-pharmacological interventions can improve hand function and performance of daily activities in individuals with a diagnosis of SSc. Given the moderate risk of bias found in the studies included, the results should be considered with caution.
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