Scleroderma

Scenario: A 40-year-old female who is a CrossFit competitor, is referred to OP PT with low back pain and generalized stiffness. While you are conducting the initial interview, you notice that her hands are getting mottled and her fingers red. She constantly rubs her fingers and periodically scratches her forearms and face. She has had some recent weight loss without dieting, and is happy about it, but not that her legs look skinnier. Upon questioning, she does describe that she is eating less because of intermittent heartburn not necessarily relieved with antacids. Observation reveals some red spots on her face, which she states have appeared over the past year or so.

Question: What are two appropriate self-care and lifestyle education topics to address with this patient?

Potential answers:

1. Diet recommendation and stretching.
2. Integumentary protection and the importance of physical activity.
3. Stretching and balance.
4. Gait training and diet recommendation.

Answer with rationale: b. Integumentary protection and the importance of physical activity. Integumentary protection helps with temperature regulation and clothing advice to stop skin injury. Recommending physical activity can improve cardiac and respiratory function, as well as increasing tolerance of activity.

For more information see Chapter 50: Scleroderma in the Color Atlas of Physical Therapy