Objectives This study aimed to investigation of the effects of the Cognitive Exercise Therapy Approach (Bilişsel Egzersiz Terapi Yaklaşımı-BETY), a supervised biopsychosocial model-based exercise intervention, on functionality, muscle strength, vascularization, anti-inflammatory and biopsychosocial status in Systemic Sclerosis (SSc) patients. Methods Thirty-seven SSc patients were included. Twenty of them were recruited into the study group (SG) undergoing BETY group exercise sessions three times a week for three months and 17 were in the control group (CG) following a home exercise program. Assessments tools were the Modified Rodnan Skin Score (mRSS), Scleroderma Health Assessment Questionnaire (SHAQ), Modified Hand Mobility in Scleroderma (mHAMIS), Duruoz Hand Index (DHI), Six Minute Walk Test (6MWT), skeletal muscle strength measurements using an isokinetic dynamometer (Biodex System 3 Pro), Shear Wave Elastography (SWE), ELISA kits (for tumor necrosis factor-alpha, Interleukin-6, IL-10, serum irisin level), BETY-Biopsychosocial Questionnaire (BETY-BQ), Hospital Anxiety and Depression Scale (HADS), and Short Form-36 (SF-36). Results The SG demonstrated improvements in SHAQ, mHAMIS, 6MWT, BETY-BQ, HADS, and SF-36 values, excluding the DHI scores (p < 0.05). In contrast, CG showed worsening in SHAQ-general scleroderma symptoms and HADS scores compared to SG (p < 0.05). IL-10 and TNF-alpha increased in both groups, also various vascular parameters were significantly different changed in SG than CG (p < 0.05). Muscle strength values improved in the SG but decreased in the CG however this was statistically not significant (p > 0.05). Conclusions BETY can be recommended as a nonpharmacologic approach to the disease management of SSc patients.

中文翻译：

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基于生物心理社会模型的运动是否可以改善 SSc 患者的功能、力量、血管化、炎症和生物心理社会状态？


目的 本研究旨在调查认知运动疗法 (Bilişsel Egzersiz Terapi Yaklaşımı-BETY)（一种基于监督生物心理社会模型的运动干预）对系统性硬化症患者功能、肌肉力量、血管化、抗炎和生物心理社会状态的影响（SSc）患者。方法 纳入 37 例 SSc 患者。其中 20 人被招募到研究组 (SG)，每周进行 3 次 BETY 小组锻炼，持续三个月，17 人被纳入对照组 (CG)，参加家庭锻炼计划。评估工具包括改良罗德南皮肤评分 (mRSS)、硬皮病健康评估问卷 (SHAQ)、改良硬皮病手部活动度 (mHAMIS)、Duruoz 手指数 (DHI)、六分钟步行测试 (6MWT)、使用等速测力计 (Biodex System 3 Pro)、剪切波弹性成像 (SWE)、ELISA 试剂盒（用于肿瘤坏死因子-α、白介素-6、IL-10、血清鸢尾素水平）、BETY-生物心理社会问卷 (BETY-BQ)、医院焦虑和抑郁量表 (HADS) 和简表 36 (SF-36)。结果 SG 表现出 SHAQ、mHAMIS、6MWT、BETY-BQ、HADS 和 SF-36 值的改善，不包括 DHI 评分 (p < 0.05)。相反，与 SG 相比，CG 的 SHAQ 一般硬皮病症状和 HADS 评分恶化（p < 0.05）。两组的 IL-10 和 TNF-α 均升高，而且 SG 组的各种血管参数变化也与 CG 组显着不同（p < 0.05）。 SG 中的肌肉力量值有所改善，但 CG 中的肌肉力量值有所下降，但这在统计上并不显着 (p > 0.05)。结论 BETY 可以推荐作为 SSc 患者疾病管理的非药物方法。