Effects of osteopathic manipulative treatment on hand function, disease symptoms and functional status in systemic sclerosis: a series of single-case studies in working women

BackgroundSome studies involving manual techniques combined with exercises have shown encouraging results in reducing disability in patients with systemic sclerosis (SSc). There is a paucity of data on the effect of osteopathic manipulative treatment (OMT) for this population.ObjectiveOur aim was to explore the effects of OMT on hand function, disease symptoms and functional status in patients with SSc.MethodsA series of single-case studies was undertaken. Six female SSc participants with hand contractures and self-reported limitations in vocational activities received 9 weekly semi-standardized OMT sessions targeting the upper limbs, thorax and cranial base. The outcomes of interest were hand stiffness, range of motion of the fingers, distal upper limbs skin score, disease symptoms (pain, dyspnea and fatigue), hand and global disability, work disability and health-related quality of life.ResultsAll participants (n = 6/6) improved in hand stiffness and in range of motion of the fingers, and most improved on distal upper limbs skin score (n = 4/6). Disease symptoms improved (pain: n = 6/6, dyspnea: n = 3/4, fatigue: n = 4/6) as did functional status (global disability: n = 5/5, work disability: n = 4/6, health-related quality of life, physical (n = 6/6) and mental (n = 4/6) components). When comparisons were possible, almost all observed improvements were greater than minimal clinically important differences suggested for this population.ConclusionThese findings suggest that OMT can be effective in relieving symptoms and reducing disability in SSc.