Rehabilitation for Arm Coordination and Hand Movement in Systemic Sclerosis

The specific aims of this study are to:

1. Determine the short and longer-term effects of an intensive (8-week in-person
occupational therapy treatment with prescribed home exercises) on improving arm function
versus home exercise alone.

This study's hypothesis is that immediately following treatment at 8 weeks and at 18
weeks, participants randomized to the in-person occupational therapy will have
significant improvements in the QuickDASH disability measure, PROMIS physical function
measure, and total active hand function compared to the home exercise alone.

2. Determine how adherence to home exercise in both groups influences treatment effects.

This study's hypothesis is that adherence will independently predict improvement in outcomes
at 8 and 18 weeks regardless of treatment group assignment and that higher adherence to the
home exercise program will result in greater and more long-lasting improvements.

Inclusion Criteria:

- Have a diagnosis of systemic sclerosis including:

- Diffuse cutaneous subset

- Disease duration < 5 years from 1st non Raynaud phenomenon sign or symptom

- Have a contracture of the hand and other joint in at least one arm, such as wrist,
elbow, or shoulder, with the ability to demonstrate active range of motion in that arm

- Willing to travel to participate in therapy and outcome assessments.

- Have an Android, iPhone, iPad or computer tablet to load the home exercise App.

- English speaking

Exclusion Criteria:

- issues that preclude meaningful participation in study procedures (e.g. concurrent or
complex medical issues, inability to use home exercise app, etc.)