to evaluate the efficacy of the Polarized light therapy and Hand Grip Strengthening exercises in patients with CREST syndrome

Measurement of the skin thickness via the modified Rodnon skin score (RSS) and Hand Grip Dynamometer (HGD) . Methods:- Sixty patients, who had hand involvement of children with localized scleroderma, were participated in the study. Their ages were ranged from 8 to 11 years. The participants were selected from the dermatology departments of Cairo university hospitals and Om El-Misrieen hospital, randomly distributed into three equal groups. Group A: (Study group): This group included 7 patients who had localized scleroderma in the dorsum of hands and who received the BLT with traditional physical therapy program (stretching, strengthening and active exercise) patients received 3 sessions per week for 12 weeks (3 months),time of session is 15 minutes. Group B: This group included 7 patients who have localized scleroderma in the dorsum of hands and who received resisted exercise with traditional physical therapy program (stretching, strengthening and active exercise) patients received 3 sessions per week for 12 weeks (3 months), time of session is 15 minutes and Group C:This group included 7 patients who had localized scleroderma in the dorsum of hands and who received combination of (BLT and resisted exercise) with traditional physical therapy program (stretching, strengthening and active exercise) exercise program (stretching, strengthening and active exercise).Patients received 3 sessions per week for 12weeks (3 months), the time of each session was 15 minutes.

Inclusion Criteria:

• The patients' ages ranged from 8 to 11 years.
• Patients who had hand involvement of patients with localized scleroderma, particularly dorsum of the hand.
• All patients were conscious.
• All patients were randomly chosen (male and female).

Exclusion Criteria:

• Patients who are diabetic or hypertensive.
• Patients those familiar with the BLT and resisted exercise via the hand grip strengthener.
• Patients with hemorrhage specially hemorrhage of digestive system and those with bleeding per rectum.
• Patients with severe fungal diseases and acute viral diseases.
• Patients with active tuberculosis and tumors as well as those with peacemakers.
• Patients with thyroid problems

this proposal was assigned to evaluate skin thickness and pinch gauge concerning hand function using Bioptron light therapy in patients with crest syndrome

masking was done by sealed envelopes