Strengthening and stretching for rheumatoid arthritis of the hand SARAH: design of a randomised controlled trial of a hand and upper limb exercise intervention - ISRCTN89936343Report as inadecuate




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 - Download this document for free, or read online. Document in PDF available to download.

BMC Musculoskeletal Disorders

, 13:230

Rehabilitation, physical therapy and occupational health

Abstract

BackgroundRheumatoid 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-design480 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.

DiscussionThis 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.

Trial registrationCurrent Controlled Trials ISRCTN89936343

KeywordsRandomised controlled trial Rheumatoid arthritis Exercise Hand Rehabilitation Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-230 contains supplementary material, which is available to authorized users.

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Author: Sarah Trial Team - Jo Adams - Chris Bridle - Sukhdeep Dosanjh - Peter Heine - Sarah E Lamb - Joanne Lord - Christopher McC

Source: https://link.springer.com/







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