Scleroderma Physical Therapy: Start, Stop, and Why It Matters for Mobility

Scleroderma, also known as systemic sclerosis, can cause skin tightening, joint stiffness, muscle weakness, and reduced endurance. These changes may affect walking, transfers, hand function, and everyday activities.

Scleroderma physical therapy focuses on maintaining mobility, improving function, and helping patients remain as independent as possible.

START: Keep the Body Moving

Start with gentle, functional activities that match the patient's ability.

• Start with range-of-motion exercises

  A patient with stiff fingers practices gentle finger opening and closing to maintain available movement.

• Start functional strengthening

  Practice 5 sit-to-stands from a chair to improve strength needed for getting up from the toilet or dining chair.

• Start short, manageable activity periods

  Instead of walking for 20 minutes continuously, begin with 5 minutes of walking followed by a rest period.

• Start breathing and posture exercises when appropriate

  Practice diaphragmatic breathing during seated exercises to encourage better breathing control.

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STOP: Don't Push Through Warning Signs

Stop or modify the activity when symptoms indicate that the patient may need a break or reassessment.

• Stop if pain significantly increases

  If hand pain increases from 3/10 to 7/10 during an exercise, reduce the intensity and reassess.

• Stop if the patient becomes unusually short of breath or dizzy

  A patient becomes noticeably breathless during walking. Pause the activity, allow recovery, and reassess before continuing.

• Stop when circulation or skin problems become concerning

   If a patient's fingers become unusually pale, blue, painful, or develop a wound, pause the activity and follow the appropriate medical plan.

  
  

WHY: Focus on What the Patient Needs to Do

The purpose of scleroderma physical therapy is to improve function—not simply to complete exercises.

• Why work on transfers?

  So the patient can get out of bed or stand from a chair more safely.

• Why work on hand mobility?

  So the patient can perform tasks such as dressing, holding utensils, or using a phone.

• Why work on endurance?

  So the patient can walk through the home, prepare a meal, or complete daily activities with fewer rest breaks.

• Why use adaptive equipment?

  A raised toilet seat, walker, or other device may make an everyday task safer and less physically demanding.