PMID- 21312348
OWN - NLM
STAT- MEDLINE
DCOM- 20110802
LR  - 20111209
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 63
IP  - 6
DP  - 2011 Jun
TI  - Randomized comparison of a multidisciplinary team care program with usual care in 
      patients with systemic sclerosis.
PG  - 909-17
LID - 10.1002/acr.20448 [doi]
AB  - OBJECTIVE: To compare the effectiveness of a multidisciplinary team care program 
      with usual outpatient care in patients with systemic sclerosis (SSc; 
      scleroderma). METHODS: We performed a randomized controlled trial comparing a 
      12-week multidisciplinary team care program (1 day per week; individual 
      treatments, group exercises, and group education) with outpatient clinic care. 
      Outcome measures included the Hand Mobility in Scleroderma (HAMIS) test, grip 
      strength, maximal mouth opening (MMO), 6-minute walk distance (6MWD), maximum 
      aerobic capacity (VO(2max) ), Checklist Individual Strength 20 (CIS-20), SSc 
      Health Assessment Questionnaire (HAQ), and Short Form 36 (SF-36), assessed at 0, 
      12, and 24 weeks. Statistical comparisons of change scores were done by analysis 
      of covariance. RESULTS: Twenty-eight patients were assigned to the intervention 
      group (mean age 53.9 years, 15 of 28 with diffuse SSc) and 25 were assigned to 
      the control group (mean age 51.7 years, 15 of 25 with diffuse SSc). Twenty-five 
      patients (89%) in the intervention group completed the treatment program. At 12 
      weeks, there was a significantly greater improvement in grip strength (2.2 versus 
      -1.8 kg; P = 0.001), MMO (1.4 versus -0.9 mm; P = 0.011), 6MWD (42.8 versus 3.9 
      meters; P = 0.021), and HAQ score (-0.18 versus 0.13; P = 0.025) in the 
      intervention group, whereas differences for the other outcome measures did not 
      reach significance. At 24 weeks, the effect on grip strength persisted. 
      CONCLUSION: In patients with SSc, a 12-week multidisciplinary day patient 
      treatment program was more effective than regular outpatient care with respect to 
      6MWD, grip strength, MMO, and HAQ score, but not for VO(2max) , HAMIS test, 
      CIS-20, SF-36, and visual analog scale for pain. This study provides a first step 
      in quantifying the effect of a multidisciplinary team care program and warrants 
      the conduct of further intervention studies.
CI  - Copyright (c) 2011 by the American College of Rheumatology.
FAU - Schouffoer, A A
AU  - Schouffoer AA
AD  - Leiden University Medical Center, Leiden, The Netherlands. A.A.Schouffoer@LUMC.nl
FAU - Ninaber, M K
AU  - Ninaber MK
FAU - Beaart-van de Voorde, L J J
AU  - Beaart-van de Voorde LJ
FAU - van der Giesen, F J
AU  - van der Giesen FJ
FAU - de Jong, Z
AU  - de Jong Z
FAU - Stolk, J
AU  - Stolk J
FAU - Voskuyl, A E
AU  - Voskuyl AE
FAU - Scherptong, R W C
AU  - Scherptong RW
FAU - van Laar, J M
AU  - van Laar JM
FAU - Schuerwegh, A J M
AU  - Schuerwegh AJ
FAU - Huizinga, T W J
AU  - Huizinga TW
FAU - Vlieland, T P M Vliet
AU  - Vlieland TP
LA  - eng
SI  - ISRCTN/ISRCTN64237175
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
SB  - IM
MH  - Adult
MH  - Ambulatory Care/methods/*standards
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Care Team/*standards
MH  - Scleroderma, Systemic/physiopathology/*therapy
MH  - Treatment Outcome
EDAT- 2011/02/12 06:00
MHDA- 2011/08/04 06:00
CRDT- 2011/02/12 06:00
PHST- 2011/02/12 06:00 [entrez]
PHST- 2011/02/12 06:00 [pubmed]
PHST- 2011/08/04 06:00 [medline]
AID - 10.1002/acr.20448 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2011 Jun;63(6):909-17. doi: 10.1002/acr.20448.