Table 1. Treatment Protocol.

Focus Area	Technique
Preparation for Treatment	Thermal Modalities ■Hot packs – focused on areas with limitations ■Paraffin – focused on digital limitations
Tissue Mobilization	Physiotouch ■Applied proximal to distal in areas with pathological skin in sections
Arm Mobility	Passive Range of Motion ■Hold end position of joint for 3-10 seconds. (Dependent on skin and joint integrity) ■Repeat for each affected joint/digit Active Range of Motion Functional Activities (limited due to time)
Home Range of Motion Exercises	■Tailored active and passive ROM based on limitations in upper extremity mobility