{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:33:17Z","timestamp":1787009597880,"version":"build-2736575974"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>SSc often leads to fibrotic cutaneous involvement of the face and reduced oral aperture, with impaired food intake and oral hygiene. Oral exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore the feasibility, patient satisfaction and effectiveness of two exercise programmes in SSc-associated microstomia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients suffering from SSc and microstomia (maximal oral aperture &amp;lt;40\u2009mm) were randomized to two groups. Group A exercised with a jaw motion device (Therabite), whereas group B performed mouth-stretching exercises. Patients were expected to exercise for 10\u2009min, three times per day for 3\u2009months. Patients were evaluated at baseline, 3\u2009months (period without intervention), 6\u2009months (after 3\u2009months of intervention) and 9\u2009months (post-intervention). At month\u20096, semi-structured one-to-one interviews were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included six women and three men, median age 60\u2009years and median disease duration 8\u2009years. At 6\u2009months, all patients in group A (n\u2009=\u20094) and four in group B (n\u2009=\u20095) improved, with a median of 9 and 7\u2009mm, respectively. The adherence ranged between 63.7 and 98.9% in group A and between 48.5 and 97.4% in group B. The interview revealed three themes: drivers, challenges and perceived improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both interventions improved maximal oral aperture. The adherence to therapy was high, but none of the patients considered it feasible to continue practising three times per day. Future studies are needed in order to define feasible long-term exercise programmes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkab017","type":"journal-article","created":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T14:09:14Z","timestamp":1615126154000},"source":"Crossref","is-referenced-by-count":4,"title":["A mixed method study exploring patient satisfaction and feasibility of two exercise programmes in systemic sclerosis-associated microstomia"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-9353","authenticated-orcid":false,"given":"Ellinor","family":"Sydow","sequence":"first","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristien","family":"Van der Elst","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Verschueren","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Lenaerts","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Westhovens","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4045-2146","authenticated-orcid":false,"given":"Ellen","family":"De Langhe","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University Hospitals Leuven"},{"name":"Laboratory of Tissue Homeostasis and Disease, Department of Development and Regeneration, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2021051314272301200_rkab017-B1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/BOR.0b013e3283367c17","article-title":"The genetics of scleroderma (systemic sclerosis)","volume":"22","author":"Agarwal","year":"2010","journal-title":"Curr Opin Rheumatol"},{"key":"2021051314272301200_rkab017-B2","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1002\/acr.20480","article-title":"Recommendations for the care of oral involvement in patients with systemic sclerosis","volume":"63","author":"Alantar","year":"2011","journal-title":"Arthritis Care Res"},{"key":"2021051314272301200_rkab017-B3","doi-asserted-by":"crossref","first-page":"814","DOI":"10.14219\/jada.archive.1982.0466","article-title":"Oral management of the scleroderma patient","volume":"105","author":"Naylor","year":"1982","journal-title":"J Am Dent Assoc"},{"key":"2021051314272301200_rkab017-B4","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s00296-010-1382-9","article-title":"The rehabilitation of facial involvement in systemic sclerosis: efficacy of the combination of connective tissue massage, Kabat\u2019s technique and kinesitherapy: a randomized controlled trial","volume":"31","author":"Maddali-Bongi","year":"2011","journal-title":"Rheumatol Int"},{"key":"2021051314272301200_rkab017-B5","first-page":"831","article-title":"Small mouths \u2026 big problems? 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