Abstract
Introduction: The Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a tailored, 12-week hand and arm exercise program recommended in the National Institute for Health and Care Excellence guidelines. It includes seven mobility exercises and four strength exercises against resistance. An online version of the SARAH program (mySARAH) has been developed to allow direct access for people with rheumatoid arthritis. Purpose: The purpose of this study was to assess the feasibility, acceptability, and clinical impact of mySARAH in people with rheumatoid arthritis. Study Design: This is a mixed-method, proof-of-concept study. Methods: mySARAH is a self-guided, online version of the SARAH program with six exercise training and review sessions. Participants were observed as they worked through four of the six online sessions. They were also asked to demonstrate the SARAH exercises. Participants undertook two sessions independently at home. At the baseline and 12 weeks, hand pain, hand function, and grip strength were measured. At 12 weeks, feedback on mySARAH, and perceived recovery were also collected. Approximately one month later, a telephone follow-up was conducted to explore participants' experiences with mySARAH. Pain, hand function, and perceived recovery were also assessed. Results: Eleven participants (males/females: 3/8) with a median (interquartile range) age of 63 (17) years took part. Six participants completed all mySARAH sessions. About 512 exercise and load-setting demonstrations were observed and 491 (96%) were performed correctly. Improvements in grip strength and hand function were observed with no increase in pain. Most of the participants reported improvement and provided positive feedback. All participants perceived mySARAH as a useful resource. Features to improve the online exercise diary such as recording and tracking exercise dose and face-to-face or remote support by phone or Skype from health professionals were suggested to optimize user engagement. Conclusions: Initial evaluation of mySARAH indicates that mySARAH was feasible, acceptable, and beneficial to participants. Further iteration and evaluation are needed before large-scale implementation.
| Original language | English |
|---|---|
| Journal | Journal of Hand Therapy |
| DOIs | |
| Publication status | Accepted/In press - 2020 |
Bibliographical note
Funding Information:The authors would like to thank and acknowledge the contribution of all participants who took part in this study. The authors would like to thank Joanne Macdonald, Senior research nurse at the Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, for her support in site setup and recruitment process. This research is funded by the National Institute for Health Research Collaboration for Leadership for Applied Health Research and Care (NIHR CLAHRC) Oxford, United Kingdom. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health and Social Care.
Funding Information:
This research is funded by the National Institute for Health Research Collaboration for Leadership for Applied Health Research and Care (NIHR CLAHRC) Oxford, United Kingdom. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health and Social Care.
Publisher Copyright:
© 2020 Hanley & Belfus
Keywords
- Acceptability
- Feasibility
- Hand function
- Online exercise intervention
- Proof-of-concept
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation
- Rehabilitation