Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Nov 24:13:230.
doi: 10.1186/1471-2474-13-230.

Strengthening and stretching for rheumatoid arthritis of the hand (SARAH): design of a randomised controlled trial of a hand and upper limb exercise intervention--ISRCTN89936343

Sarah Trial Team  1 ; Jo Adams, Chris Bridle, Sukhdeep Dosanjh, Peter Heine, Sarah E Lamb, Joanne Lord, Christopher McConkey, Vivien Nichols, Francine Toye, Martin R Underwood, Mark A Williams, Esther M Williamson
Collaborators, Affiliations
Randomized Controlled Trial

Strengthening and stretching for rheumatoid arthritis of the hand (SARAH): design of a randomised controlled trial of a hand and upper limb exercise intervention--ISRCTN89936343

Sarah Trial Team et al. BMC Musculoskelet Disord. .

Abstract

Background: Rheumatoid Arthritis (RA) commonly affects the hands and wrists with inflammation, deformity, pain, weakness and restricted mobility leading to reduced function. The effectiveness of exercise for RA hands is uncertain, although evidence from small scale studies is promising. The Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH) trial is a pragmatic, multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of adding an optimised exercise programme for hands and upper limbs to best practice usual care for patients with RA.

Methods/design: 480 participants with problematic RA hands will be recruited through 17 NHS trusts. Treatments will be provided by physiotherapists and occupational therapists. Participants will be individually randomised to receive either best practice usual care (joint protection advice, general exercise advice, functional splinting and assistive devices) or best practice usual care supplemented with an individualised exercise programme of strengthening and stretching exercises. The study assessors will be blinded to treatment allocation and will follow participants up at four and 12 months. The primary outcome measure is the Hand function subscale of the Michigan Hand Outcome Questionnaire, and secondary outcomes include hand and wrist impairment measures, quality of life, and resource use. Economic and qualitative studies will also be carried out in parallel.

Discussion: This paper describes the design and development of a trial protocol of a complex intervention study based in therapy out-patient departments. The findings will provide evidence to support or refute the use of an optimised exercise programme for RA of the hand in addition to best practice usual care.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of study design.
Figure 2
Figure 2
Flowchart of interventions.
See this image and copyright information in PMC

References

    1. Symmons D, Turner G, Webb R, Asten P, Barrett E, Lunt M, Scott D, Silman A. The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century. Rheumatology (Oxford) 2002;41(7):793–800. doi: 10.1093/rheumatology/41.7.793. - DOI - PubMed
    1. Young A, Dixey J, Cox N, Davies P, Devlin J, Emery P, Gallivan S, Gough A, James D, Prouse P. et al.How does functional disability in early rheumatoid arthritis (RA) affect patients and their lives? Results of 5 years of follow-up in 732 patients from the Early RA Study (ERAS) Rheumatology (Oxford) 2000;39(6):603–611. doi: 10.1093/rheumatology/39.6.603. - DOI - PubMed
    1. Adams J, Burridge J, Mullee M, Hammond A, Cooper C. Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clin Rehabil. 2004;18(4):405–413. doi: 10.1191/0269215504cr732oa. - DOI - PubMed
    1. American College Of Rheumatology. Guidelines for the management of rheumatoid arthritis: 2002 Update. Arthritis Rheum. 2002;46(2):328–346. - PubMed
    1. Deighton C, O’Mahony R, Tosh J, Turner C, Rudolf M, Group GD. Management of rheumatoid arthritis: summary of NICE guidance. BMJ. 2009;338:b702. doi: 10.1136/bmj.b702. - DOI - PMC - PubMed

Publication types

MeSH terms

Associated data