Protocol-guided rehabilitation in systemic sclerosis: Five-year functional outcomes within real-world clinical constraints
JOURNAL OF BODYWORK AND MOVEMENT THERAPIES, cilt.48, ss.669-680, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 48
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jbmt.2026.07.033
- Dergi Adı: JOURNAL OF BODYWORK AND MOVEMENT THERAPIES
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, MEDLINE, SportDiscus
- Sayfa Sayıları: ss.669-680
- İstanbul Üniversitesi Adresli: Hayır
Özet
Background: The ideal conditions frequently described in research settings are not always achievable in real-world clinical practice. Objective: This study aimed to examine the functional outcomes and clinical applicability of a protocol-guided rehabilitation program in systemic sclerosis (SSc) under constrained clinical conditions over a five-year follow-up. Methods: This retrospective cohort study analyzed rehabilitation records of patients with SSc who completed a protocol-guided program and provided post-intervention data. Patients were assigned to one of two individualized protocols according to disease phase and functional status, with flexibility to transition between protocols during follow-up. All interventions were delivered by a single therapist. Outcomes were assessed at baseline (T0), one year (T1), and five years (T5) using standardized measures. Primary outcomes were hand function and physical disability; secondary outcomes included hand mobility, maximum interincisal opening, hand strength, pain intensity, perceived health status, and skin thickness. Results: Sixty-six patients were enrolled, of whom 56 (85%) completed T1 and 34 (52%) remained in protocol-based follow-up at T5. Primary outcomes improved significantly at T1 (p < 0.001), but deteriorated at T5 (p < 0.001). Secondary outcomes followed a similar pattern, showing significant overall changes over time (p < 0.001). Skin thickness did not change at T1, but decreased at T5 (p < 0.001). Conclusions: Protocol-guided rehabilitation tailored to disease phase and functional status can produce clinically meaningful short-term improvements in patients with SSc, even under constrained clinical conditions. However, five-year declines highlights the need for sustained, adaptable rehabilitation and earlier referral to optimize longterm outcomes.