Hand exercises for patients with rheumatoid arthritis: an extended follow-up of the SARAH randomised controlled trial. Issue 4 (12th April 2017)

• Record Type: Journal Article
• Authors: Williamson, Esther; McConkey, Christopher; Heine, Peter; Dosanjh, Sukhdeep; Williams, Mark; Lamb, Sarah E
• Other Names: Adams J author non-byline.; Underwood MR author non-byline.; Lord J author non-byline.; Rahman A author non-byline.; Lowe S author non-byline.; Campbell A author non-byline.; Rattigan L author non-byline.; Nichols V author non-byline.; Lord J author non-byline.; Crossan C author non-byline.; Dritsaki M author non-byline.; Glover M author non-byline.; Neely Olivia author non-byline.; Gibson Catherine author non-byline.; Hotchkiss Karen author non-byline.; Chilton Frances author non-byline.; Thrush Jessica author non-byline.; Minns-Lowe Catherine author non-byline.; Birch Ann author non-byline.; Webber Linda author non-byline.; Clague Nicola author non-byline.; Kennedy Sue author non-byline.; Spear Kevin author non-byline.; Derham Sandi author non-byline.; Lewis Jenny author non-byline.; Bradley Sarah author non-byline.; Cottrell Julie author non-byline.; White Paula author non-byline.; Frosdick Carole author non-byline.; Wilson Jennifer author non-byline.; Bassett-Burr Nicola author non-byline.; Walsh Maggie author non-byline.; Myshrall Lynda author non-byline.; Tooby Jane author non-byline.; Steinberg Cherry author non-byline.; Grant Mary author non-byline.; Handley Roslyn author non-byline.; Jones Fiona author non-byline.; Pheasant Clare author non-byline.; Hynes Kate author non-byline.; Kelly Sue author non-byline.; Newbold Joanne author non-byline.; Thurgarland Sally author non-byline.; Dickenson Jane author non-byline.; Mann Lucy author non-byline.; Hinton Alison author non-byline.; Chapman Rachel author non-byline.; Farmah Sunita author non-byline.; James Collette author non-byline.; Wiltshire Janice author non-byline.; Simons Jane author non-byline.; Martindale Jane author non-byline.; Hesketh Susan author non-byline.; Gerrard Alison author non-byline.; Bancroft Kirsty author non-byline.; Cheng Corinna author non-byline.; Wood Caroline author non-byline.; Small Lisa author non-byline.; Coales Karen author non-byline.; Ibbunson Helen author non-byline.; Bonsall Anne author non-byline.; Mountain Caroline author non-byline.; Gibbons Jonathan author non-byline.; Mavurah Esther author non-byline.; Susans Hannah author non-byline.; Spear Nicola author non-byline.; Shaylor Becky author non-byline.; Ghulam Leon author non-byline.; Wastell Sarah author non-byline.; MacLeod Christina author non-byline.; Patterson Sapphire author non-byline.; Vadher Jane author non-byline.; Barker Karen author non-byline.; Gosling Sue author non-byline.; Sander-Danby Lizelle author non-byline.; Room Jon author non-byline.; Fenn Aimee author non-byline.; Richards Anne author non-byline.; Clarke Pam author non-byline.; Rowbotham Gill author non-byline.; Nolan Nicky author non-byline.; Kendall Lorraine author non-byline.; Charnley Claire author non-byline.; Richardson Laura author non-byline.; Wakefield Kate author non-byline.; Jansen Victoria author non-byline.; Radbourne Liz author non-byline.; Tougher Julie author non-byline.;
• Is Part Of: BMJ open. Volume 7:Issue 4(2017)
• Publication Date: 2017-04-12
• Subjects: Exercise -- Adherance -- Rheumatoid Arthritis -- Hand therapy; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-013121
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: The Stretching And strengthening for Rheumatoid Arthritis of the Hand (SARAH) randomised controlled trial evaluated the effectiveness of a hand exercise programme and demonstrated it was clinically effective and cost-effective at 12 months. The aim of this extended follow-up was to evaluate the effects of the SARAH programme beyond 12 months. Methods: Using postal questionnaires, we collected the Michigan Hand Questionnaire hand function (primary outcome), activities of daily living and work subscales, pain troublesomeness, self-efficacy and health-related quality of life. All participants were asked how often they performed hand exercises for their rheumatoid arthritis. Mean difference in hand function scores were analysed by a linear model, adjusted for baseline score. Results: Two-thirds (n=328/490, 67%) of the original cohort provided data for the extended follow-up. The mean follow-up time was 26 months (range 19–40 months). There was no difference in change in hand function scores between the two groups at extended follow-up (mean difference (95% CI) 1.52 (−1.71 to 4.76)). However, exercise group participants were still significantly improved compared with baseline (p=0.0014) unlike the best practice usual care group (p=0.1122). Self-reported performance of hand exercises had reduced substantially. Conclusions: Participants undertaking the SARAH exercise programme had improved hand function compared with baseline >2 years after randomisation. This was not the case for the control group. However, scores were no longer statistically different between the groups indicating the effect of the programme had diminished over time. This reduction in hand function compared with earlier follow-up points coincided with a reduction in self-reported performance of hand exercises. Further intervention to promote long-term adherence may be warranted. Trial registration number: ISRCTN89936343 ; Results.