Do functionality, strength, vascularization, inflammatory and biopsychosocial status improve by biopsychosocial model-based exercise in SSc?

Abstract

This study aimed to investigation of the effects of the Cognitive Exercise Therapy Approach [Bilişsel Egzersiz Terapi Yaklaşımı (BETY)], a supervised biopsychosocial model-based exercise intervention, on functionality, muscle strength, vascularization, anti-inflammatory and biopsychosocial status in SSc patients. Thirty-seven SSc patients were included. Twenty of them were recruited into the study group (SG) undergoing BETY group exercise sessions three times a week for 3 months and seventeen were in the control group (CG) following a home exercise program. Assessment tools were the Modified Rodnan Skin Score (mRSS), Scleroderma HAQ (SHAQ), Modified Hand Mobility in Scleroderma (mHAMIS), Duruoz Hand Index (DHI), Six-Min Walk Test (6-MWT), skeletal muscle strength measurements using an isokinetic dynamometer (Biodex System 3 Pro), Shear Wave Elastography, ELISA kits (for tumour necrosis factor-alpha, Interleukin-6, IL-10, serum irisin level), BETY-Biopsychosocial Questionnaire (BETY-BQ), Hospital Anxiety and Depression Scale (HADS) and Short Form-36 (SF-36). The SG demonstrated improvements in SHAQ, mHAMIS, 6-MWT, BETY-BQ, HADS and SF-36 values, excluding the DHI scores (P < 0.05). In contrast, CG showed worsening in SHAQ-general scleroderma symptoms and HADS scores compared with SG (P < 0.05). IL-10 and TNF-alpha increased in both groups, also various vascular parameters were significantly different changed in SG than CG (P < 0.05). Muscle strength values improved in the SG but decreased in the CG, however, this was statistically not significant (P > 0.05). BETY can be recommended as a non-pharmacological approach to the disease management of SSc patients.