{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:10:14Z","timestamp":1789431014995,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T00:00:00Z","timestamp":1540512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24\u2010AR\u2010063120"],"award-info":[{"award-number":["K24\u2010AR\u2010063120"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the feasibility and preliminary effects of occupational therapy to improve upper extremity function in patients with early systemic sclerosis (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c; scleroderma) who have upper extremity contractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010group pilot clinical rehabilitation trial was conducted at the University of Michigan Scleroderma Center. Patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c and \u22651 upper extremity contracture (n = 21) participated in a total of 8 weekly in\u2010person occupational therapy sessions. The therapy consisted of thermal modalities, tissue mobilization, and upper extremity mobility exercises. The participants were instructed to perform upper extremity exercises at home between sessions. Feasibility was measured by the percent enrollment as well as session attendance and session duration. The primary outcome measure was the Shortened Disabilities of the Arm, Shoulder and Hand measure (Quick<jats:styled-content style=\"fixed-case\">DASH<\/jats:styled-content>); secondary and exploratory outcomes included the Patient\u2010Reported Outcomes Measurement Information System (<jats:styled-content style=\"fixed-case\">PROMIS<\/jats:styled-content>) physical function measures; objective measures of upper extremity mobility, strength, and coordination; and skin thickening. Linear mixed models were used to determine the effects of treatment on the primary and secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty percent of potentially eligible subjects (24 of 48) were interested in participating. Twenty\u2010one (88%) of the 24 subjects were enrolled, and 19 (91%) of these 21 subjects completed all sessions. The mean \u00b1 <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> age of the participants was 47.9 \u00b1 16.1 years; 100% had diffuse <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c, and the mean disease duration was 3.1 years. At 8 weeks, participants had statistically significant improvement in the Quick<jats:styled-content style=\"fixed-case\">DASH<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PROMIS<\/jats:styled-content> physical function measure (<jats:italic>P<\/jats:italic> = 0.0012 and <jats:italic>P<\/jats:italic> = 0.004, respectively). Approximately one\u2010half of participants in the sample achieved improvement in the Quick<jats:styled-content style=\"fixed-case\">DASH<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PROMIS<\/jats:styled-content> measure that exceeded minimally important differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In\u2010person treatment sessions were feasible in the patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c and resulted in statistically significant and clinically meaningful improvements in upper extremity and physical function. In future studies, the effects of SSc should be compared with those in a control condition, and the durability of treatment effects should be examined.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23522","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T13:43:56Z","timestamp":1517319836000},"page":"1653-1660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Occupational Therapy Treatment to Improve Upper Extremity Function in Individuals with Early Systemic Sclerosis: A Pilot Study"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-0012","authenticated-orcid":false,"given":"Susan L.","family":"Murphy","sequence":"first","affiliation":[{"name":"University of Michigan and VA Ann Arbor Health Care System Geriatric Research Education and Clinical Center Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Whitehouse","family":"Barber","sequence":"additional","affiliation":[{"name":"University of Michigan Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Homer","sequence":"additional","affiliation":[{"name":"University of Michigan Scleroderma Center Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Dodge","sequence":"additional","affiliation":[{"name":"University of Michigan Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary R.","family":"Cutter","sequence":"additional","affiliation":[{"name":"University of Alabama Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Khanna","sequence":"additional","affiliation":[{"name":"University of Michigan Scleroderma Center Ann 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