Highlights
- •An online version of the National Institute for Health and Care Excellence recommended SARAH (Strengthening And stretching for Rheumatoid Arthritis of the Hand) program was developed (mySARAH) that could be accessed directly by people with rheumatoid arthritis.
- •The study purpose was to evaluate the feasibility, acceptability, and clinical impact of mySARAH.
- •Of 11 enrolled, 6 participants completed all mySARAH sessions; 3 partially completed; two discontinued the program.
- •Participants improved in grip strength and hand function with no increase in pain. The majority reported improvement.
- •Most participants had positive experiences of mySARAH. Ways to maximize patient engagement with mySARAH such as support from health professionals were suggested.
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.
Keywords
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JHT Read for Credit
Quiz: # 872
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The SARAH is endorsed by the NIH and is composed of
- a.12 exercises
- b.15 exercises
- c.4 strengthening and 7 mobility exercises
- d.5 ROM and 5 grip exercises
- a.
- # 2.mySARAH is composed of _______ sessions
- a.6 online
- b.10 online
- c.8 at home
- d.4 in clinic
- a.
- # 3.Outcome measures included
- a.grip strength
- b.pain
- c.function
- d.all of the above
- a.
- # 4.Data were
- a.all quantitative
- b.all qualitative
- c.a combination of qualitative and quantitative
- d.none of the above
- a.
- # 5.mySARAH was shown to be acceptable for universal application
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: October 25, 2020
Accepted:
October 19,
2020
Received in revised form:
September 17,
2020
Received:
February 10,
2020
Identification
Copyright
© 2020 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
