The Effect of Adding Paraffin Bath to the Therapeutic Hand Exercise Programme on Hand Functions in Patients with Systemic Sclerosis: A Randomized, Controlled, Single-Blind Study

Abstract

Background/Aims: Paraffin bath therapy is used as a topical treatment for inflammatory and non-inflammatory diseases of the hands. The effects of adding paraffin bath therapy to the exercise programme on pain, hand movements, and hand function in patients with systemic sclerosis (SSc) and hand involvement were investigated.

Materials and Methods: The study included 40 patients (a total of 245 patients were screened for eligibility) with hand dysfunction (Cochin Hand Functional Scale (COCHIN) ≥ 10). The patients were randomized into a control group (exercise only) (n = 20) and a paraffin bath group (exercise and paraffin bath) (n = 20). Patients were assessed with COCHIN, Modified Hand Mobility in Scleroderma (HAMIS), Delta Finger-To-Palm (DFTP), Hand Grip Strength (HGS), and Numerical Rating Scale (NRS) at baseline, 6 and 12 weeks after treatment.

Results: Thirty-five patients (control group (n = 18), paraffin bath group (n = 17)) who had completed the study period were evaluated. There was a significant difference in the change values of the parameters COCHIN, HAMIS-Right Hand, HAMIS-Left Hand, HGS-Right Hand, and HGS-Left Hand at both the 6-week and 12-week follow-up examinations of the control and paraffin groups compared to the baseline values (P < .05 for all). In addition, there was a significant difference in the change values of the NRS and DFTP-Right Hand parameters in the paraffin bath group at both the 6-week and 12-week follow-ups, in addition to the existing parameters (P < .05 for both). When the 2 groups were compared with each other, there was a statistical difference in the NRS parameter in favor of the paraffin bath group (P = .007 in the 6th week, P < .001 in the 12th week). There was no difference between the groups for the other parameters (P > .05).

Conclusion: Therapeutic hand exercises are effective for SSc patients with impaired hand function, and the addition of paraffin baths in the exercise program reduces pain.