The association between hand disease severity and fatigue in individuals with systemic sclerosis: a scoping review.
Donnamarie Krause, Janet L Poole, Dinesh Khanna and 1 others
PMID 34388047WHAT IT FOUND
Joint involvement was the hand disease severity element most linked to fatigue in systemic sclerosis.
Digital ulcers themselves were not linked to fatigue, but their perceived interference with daily activities was.
Key findings
01Joint involvement was the hand disease severity element most linked to fatigue.
02The presence of digital ulcers was not linked to increased fatigue, but perceived interference with daily activities was related to fatigue.
03Joint severity predicted fatigue severity in a longitudinal study, but the link was not seen when pain and maladaptive coping were added to the model.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only five studies were included, and they used different ways to measure hand severity and fatigue. There was no common fatigue measure across studies. Two included articles measured joints beyond the hands, so hand-specific joint severity was not always clear. No studies measuring skin hardness were found, so that part of hand disease severity was not reviewed. Definitions of hand disability, hand function, and quality of life varied across studies. The review did not register a protocol. The review did not test rehabilitation interventions.
Declared interests
The article is listed as supported by NIH and U.S. Government research support; the authors declared no conflict of interest, funding, or commercial benefit from any author.
The easy way to misread this
Do not conclude that treating hand joints will reduce fatigue. The review found links between hand disease severity and fatigue, not effects of therapy.