Physical or occupational therapy use in systemic sclerosis: A Scleroderma Patient-centered Intervention Network cohort study
Number of pages
SourceThe Journal of Rheumatology, 46, 12, (2019), pp. 1605-1613
Article / Letter to editor
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SW OZ BSI KLP
The Journal of Rheumatology
SubjectExperimental Psychopathology and Treatment
Objective: Systemic sclerosis (SSc) is characterized by significant disability due to musculoskeletal involvement. Physical and occupational therapy (PT/OT) have been suggested to improve function. However, the rate of PT/OT utilization has been shown to be low in SSc. We aimed to identify demographic, medical, and psychological variables associated with PT/OT use in SSc. Methods: Participants were patients with SSc enrolled in the Scleroderma Patient-centered Intervention Network Cohort. We determined the rate and indication of PT/OT use in the 3 months prior to enrollment. Multivariable logistic regression was used to identify variables independently associated with PT/OT utilization. Results: Of the 1,627 SSc patients included in the analysis, 23% used PT/OT in the preceding 3 months. PT/OT use was independently associated with higher education (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.12), having moderately severe small joint contractures (OR 2.09, 95% CI 1.45 - 3.03), severe large joint contractures (OR 2.33, 95% CI 1.14 - 4.74), fewer digital ulcerations (OR 0.70, 95% CI 0.51 - 0.95), and higher disability (OR 1.54, 95% CI 1.18 - 2.02) and pain (OR 1.04, 95% CI 1.02 - 1.06) scores. The highest rate of PT/OT utilization was reported in France (43%) and lowest in the USA (17%). Conclusion: Despite the potential of PT/OT interventions to improve function, less than 1 in 4 SSc patients enrolled in a large international cohort used PT/OT services in the last 3 months. Patients who utilized PT/OT had more severe musculoskeletal manifestations and higher pain and disability.
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