Systemic Sclerosis (SS) presents peculiar clinical and functional aspects that limit activities of daily living (ADL). The hands are primarily affected, and the functional disability of the hands is one of the main components of their overall disability.

To evaluate the impact of a therapist-oriented home rehabilitation (TOHR) on the perception of difficulty in performing manual tasks and on peripheral muscle strength.

Prospective quasi-experimental, longitudinal study, including women diagnosed with SS based on the criteria of the American College of Rheumatology and the European League Against Rheumatism, from the outpatient clinic of the Pedro Ernesto University Hospital. The physiotherapist accompanied the rehabilitation of people with SS at a distance, for a period of 12 weeks. The home exercise program consisted of 3 sessions per week, including flexibility training exercises, muscle strengthening, postural control training and aerobic training and relaxation exercise. To measure the difficulty in manual tasks, the Cochin Hand Function Scale (CHFS) was used, it contains 18 items about ADL that require manual skill. There are six possible answers for each item, according to the difficulty of performing the task (0 to 5). The final score is the sum of all items and ranges from 0 to 90, the higher the score, the greater the difficulty in manual function. And to measure handgrip strength, an isometric hydraulic dynamometer (SH5001, Saehan Corporation, Korea) was used in the hand on the dominant side of the body, the highest value recorded among three measurements being considered for analysis, which followed the standardization of American Society of Hand Therapists. For comparison, the methods were applied pre-TOHR and post-TOHR.

From November 2021 to November 2022, 23 women diagnosed with SS were recruited, with 5 patients excluded due to difficulty walking (n = 3) and treatment abandonment during the study protocol (n = 2). Among the 18 patients in the sample, we found a significant drop in the CHFS test score (p = 0.009) between the evaluation [21 (4–38)] and reassessment [13 (5-21)] moments. However, we did not observe significant changes (p = 0.060) in the handgrip measured in the assessment [23 (13–26)] and in the reassessment [24 (15– 27)].

Alterations in the hands of people with SS, such as progressive thickening of the skin, tendon fibrosis, muscle fibrosis, stiffening of the palmar aponeurosis, can lead to deformities and limit the range of motion. Physical exercise programs increase the efficiency of the muscles, improve joint articulation, in addition to having benefits in blood circulation, in the local inflammatory reaction and in the reduction of tissue stiffness. In this study, this was reflected in the perception of improvement in performing manual tasks, despite we did not objectively identify an increase in handgrip strength.

A therapist-oriented home rehabilitation (TOHR) have a powerful effect on the performance of manual tasks. Thus, they should be recommended as an adjunct to the drug treatment of patients with SS, as they increase physical and functional capacity.