Eusterwiemann, K (2020) Improvement of hand and finger function in systemic sclerosis: game-based intervention informed by a 3D assessment of hand mobility. Doctoral thesis, Liverpool John Moores University.

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Abstract

Systemic sclerosis (SSc) is a rare rheumatic autoimmune disease, resulting in increased collagen production, leading to increased thickness and stiffness of the skin and reduced hand function. The hands are a critical contributor to the ability to perform activities of daily living (ADL), which is limited in patients with SSc. Therefore hand function is commonly assessed in clinics using patient-reported outcome measures (PROMs) or single distance measures during static finger flexion. In this thesis a three-dimensional motion analysis was conducted to assess the magnitude of impairment throughout functional tasks, as well as joint specific contributions to overall impairment. Study one showed that patients have significant movement impairment throughout the entire movement phase of functional tasks. Further impairments were found in all joints and movement directions, with no joint being more impaired than others. The information was then used to inform a novel rehabilitation programme. Conventional programmes focus predominantly on flexion ability and patients show low adherence rates. A portable virtual rehabilitation (VR) tool was developed for the gamification of hand exercises allowing training of both flexion-extension as well as abduction-adduction ranges. The third study, a randomised-controlled trial, evaluated the effect of exercises on the VR tool compared to physiotherapy. Ability to perform ADLs was not significantly improved after exercises. Finger dexterity and mobility were significantly improved in both groups, whereby the VR group showed greater improvement across all assessed outcome measured compared to physiotherapy. Further, patients in the VR group showed higher levels of motivation and likelihood of adherence to the exercises in the future. Overall the findings in this thesis highlighted that finger joint movement impairments are present in all joints and movement directions, as well as the suitability of virtual rehabilitation to improve or maintain hand function in patients with systemic sclerosis.

Item Type:	Thesis (Doctoral)
Uncontrolled Keywords:	Systemic sclerosis; hand function; hand movement; virtual rehabilitation
Subjects:	Q Science > QP Physiology R Medicine > RC Internal medicine > RC1200 Sports Medicine T Technology > T Technology (General)
Divisions:	Sport & Exercise Sciences
Date Deposited:	21 May 2020 10:57
Last Modified:	08 Nov 2022 15:51
DOI or ID number:	10.24377/LJMU.t.00012962
Supervisors:	Barton, G, Robinson, M and Anderson, M
URI:	https://researchonline.ljmu.ac.uk/id/eprint/12962

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