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CREDIT ARTICLE #117.

The Effect of Paraffin and Exercise on Hand Function in Persons with Scleroderma: A Series of Single Case Studies
Theresa Mancuso, MOT, OTR/L Janet L. Poole, PhD, OTR/L, FAOTA
Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, New Mexico
ABSTRACT: The purpose of this study was to investigate whether the use of paraffin and active hand exercises would improve activity and participation in persons with scleroderma. In this series of three single case studies, participants used paraffin and performed active hand exercises daily for eight weeks. To assess hand function, measures of body function/structure and activity/participation were taken at baseline, at one month and at two months after intervention. All participants experienced clinically significant improvements in both body function/structure measurements of hand function and in their ability to participate in activities. Significant improvements were found more frequently on body function/structure measures than activity/participation measures. This preliminary study lends support in favor of using paraffin and hand exercises as a treatment to improve hand function related to participation in daily activities in persons with scleroderma. Further research with a larger sample and increased variable control is needed. J HAND THER. 2009;22:71e78.

Scleroderma (systemic sclerosis) is a rheumatic, autoimmune disease characterized by thickening of the skin and other soft tissues. Although the exact pathogenesis of scleroderma is unknown, the disabling impact on individuals with the disease has been documented in several studies.1e4 Fibrotic changes in finger joints, combined with contractures caused by thickened skin, can result in a claw-like deformity of the fingers.5 The International Classification of Functioning, Disability, and Health (ICF) offers a framework from which to view the impact of scleroderma and to categorize