The short term effect of gloving in combination with Traditional Thai Massage, heat, and stretching exercise to improve hand mobility in scleroderma patients

Twenty-eight patients with SSc were random in to 2 group (14 persons per group). Group 1, All participants receive Traditional Thai Massage by a relative, hand stretching exercise, and wearing glove more than 6 hour per day (the nylon glove is worn on both hands) in 2 weeks home program. Group 2, All participants receive Traditional Thai Massage by a relative, and hand stretching exercise in 2 weeks home program. None gloving. For both groups: a) the duration and frequency of Traditional Thai Massage, 15 minute in each upper extremity and hand side, left and right; total 30 minute massage per day for 2 weeks; Massage by relative which trained by physiotherapist (single 30 minute session at baseline). b) hand stretching exercise performd by patient (self care) after Traditional Thai Massage which trained by physiotherapist. c) physiotherapist demonstrates hand stretching exercises at 30 min baseline session (Forearm pronation, Forearm supination, Wrist flexion, Wrist extension, Wrist radial/ulnar deviation, Finger abduction, Finger flexion, Finger extension, Thumb abduction/adduction and flexion/extension, Terminal pinch all finger opposite the thumb); participants then complete these stretches for 30 min once daily over 2 week period. 1.Perform everyday in 2 weeks, one session per day after receive Traditional Thai Massage. 2.Stretch to the end of the range of motion at a point of tightness, without inducing discomfort 3.Hold each stretch for 30 seconds 4.Complete 4 repetitions for each stretch on both sides. 5.Perform static stretching, that is avoiding ballistic, bouncing movement, with emphasis on muscle groups (joint) that have reduce ROM. Consequently, this was a strict precaution on hand in patients with SSc (The American College Sport Medicine [ACSM], 2006). All patients were received example picture of stretching exercise procedure on hand and daily home program exercise was record in diary. For group 1 the type of glove worn is nylon fabric glove, whether it is worn on both hands, and it is worn after Traditional Thai Massage, during the normal activity of daily living more than 6 hours per day, including the hand stretching exercises. Superficial heating is also part of the home program. It is househood material, warm water or a hot pack, about 40 Celsius degree. Apply on hand before Traditional Thai Massage 15 minute. All patients were received example picture of stretching exercise procedure on hand and daily home program exercise was record in diary and telephone visit (10 minute telephone call at 1 week in both groups.). Final test after 2 week patients will show a diary.