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AB0169 Evaluation of frequency and type of physical therapy in more than 3400 patients with systemic sclerosis
  1. D Belz1,
  2. P Moinzadeh1,
  3. N Blank2,
  4. E Siegert3,
  5. J Henes4,
  6. M Worm5,
  7. C Sunderkoetter6,
  8. M Schmalzing7,
  9. A Kreuter8,
  10. C Gunther9,
  11. L Susok10,
  12. G Zeidler11,
  13. I Koetter12,
  14. U Mueller-Ladner13,
  15. T Krieg1,
  16. A Juche14,
  17. T Schmeiser15,
  18. G Riemekasten16,
  19. E Aberer17,
  20. N Gaebelein-Wissing18,
  21. JHW Distler19,
  22. M Sárdy20,
  23. C Pfeiffer21,
  24. K Kuhr22,
  25. N Hunzelmann1
  1. 1Dermatology, University Hospital Cologne, Cologne
  2. 2Rheumatology, University Hospital Heidelberg, Heidelberg
  3. 3Rheumatology, Charité Universitätsmedizin Berlin, Berlin
  4. 4Rheumatology, University Hospital Tuebingen, Tuebingen
  5. 5Dermatology, Charité Universitätsmedizin Berlin, Berlin
  6. 6Dermatology, University Hospital Muenster, Muenster
  7. 7Rheumatology, University Hospital Wuerzburg, Wuerzburg
  8. 8Dermatology, HELIOS St. Elisabeth Klinik Oberhausen, Oberhausen
  9. 9Dermatology, University Hospital Carl Gustav Carus, Dresden
  10. 10Dermatology, St. Josef Hospital Bochum, Bochum
  11. 11Rheumatology, Johanniter-Krankenhaus im Fläming Treuenbrietzen, Treuenbrietzen
  12. 12Rheumatology, Asklepios Klinik Altona, Hamburg
  13. 13Rheumatology, Justus Liebig University Giessen, Kerckhoff Clinic, Bad Nauheim
  14. 14Immanuel Krankenhaus Berlin-Buch, Berlin
  15. 15Rheumatology, Krankenhaus St. Josef, Wuppertal
  16. 16Rheumatology, University Medical Center-UKSH, Luebeck, Germany
  17. 17Dermatology, Medical University of Graz, Graz, Austria
  18. 18Dermatology, HELIOS University Hospital Wuppertal, Wuppertal
  19. 19Rheumatology, University Hospital Erlangen, Erlangen
  20. 20Dermatology, Ludwig Maximilians University Hospital, Munich
  21. 21Dermatology, University Medical Center Ulm, Ulm
  22. 22IMSIE, University of Cologne, Cologne, Germany

Abstract

Background Systemic sclerosis (SSc) is a chronic fibrosing autoimmune disease which leads to severe musculoskeletal dysfunction, disability and contractures. Little is known on the type and extent of physical therapy (PT) prescribed to SSc patients in daily practice.

Objectives To determine the type and frequency of PT received by SSc patients.

Methods The data of 3430 clinically well defined SSc patients registered in the database of the German Network for Systemic Sclerosis were analyzed using SPSS.

Results 48,5% (1662/3430) of the patients were treated with PT. The most frequently used form of PT was lymphatic drainage (23,6%/876), followed by physical exercise therapy (22%/817) and paraffin wax bath (10,5%/389). About half of the patients (46,9%) received two or three different forms of PT simultaneously. The prescription of PT did not correlate with the SSc subtype, as 49,5% (503/1016) of dcSSc patients, 50,3% (850/1689) of lcSSc patients and 45,7% (143/313) of SSc-Overlap patients received PT. PT was significantly more often prescribed to patients with pulmonary fibrosis in 51,1% (617/1208), synovitis in 61,6% (299/485) and CK elevation in 61,1% (174/285) (p=0,001–0,029). PT did not correlate with the extent of skin fibrosis as measured by mRSS. Interestingly, patients with joint contractures (45,5%) (388/853) or tendon friction rubs (40,6%) (114/281) received significantly less often PT (p=0,006/ 0,045). Comparing the prescription of PT during the initial period 2003–2008 (49,1%; 1937/3942) with the follow up period 2009–2013 (45,3%; 2217/4899), a significant decrease of PT prescription was observed (p<0,001). Patterns of PT prescription differed significantly between medical subspecialties (p<0,005) i.e. rheumatologists, dermatologists.

Conclusions Although SSc is characterized by considerable disability and restriction of motion, less than 50% of patients received PT. The significant decrease in PT prescription during recent years may reflect lack of knowledge how to prescribe PT and more restrictive insurance regulations.

Disclosure of Interest None declared

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