Warwick: A new study is published today in The
Lancet and shows a tailored hand exercise programme improves function
and quality of life for patients living with Rheumatoid Arthritis (RA). RA affects more than 400,000 people in the UK, of whom about 80% have
hand and wrist problems, and this has a substantial impact on quality
of life, function and productivity. The new strengthening and stretching
exercise programme developed for the study is a worthwhile, low cost
intervention to adopt alongside medication.
The Strengthening And Stretching For Rheumatoid Arthritis of the Hand
(SARAH) trial evaluated the effectiveness and cost-effectiveness of
adding an individually tailored, progressive exercise programme for the
hands and upper limbs in addition to usual care.
Approximately 80% of the patients using the SARAH programme alongside
their medication, reported improvement of hand function a year after
starting the programme. Significant improvements in strength and
dexterity were also seen for patients performing the exercise programme.
Mark Williams, Research Fellow at NDORMS, says: “Current best
practice mandates medication regimens, which substantially improve
control of disease activity and joint damage, but don’t always impact on
disability and health related quality of life. By adding an optimised
exercise programme for hands and upper limbs to usual care for patients
with RA, we can addresses key issues of this debilitating condition to
help patients in their daily lives.”
Professor Karen Middleton, chief executive of the Chartered Society
of Physiotherapy, added: “This study demonstrates the significant
improvement physiotherapy can make to the quality of life of people with
long-term conditions. Growing numbers of people are living with at
least one of these conditions, so new interventions such as this will be
invaluable as the NHS looks to address that rising demand within
restrained budgets. This proactive approach enables people to manage
their own condition and lead full and active lives while cutting costs
for the NHS and social care.”
As part of the study, the team developed a manual that describes the
treatment programme developed for the SARAH trial. The manual is
designed to guide hand therapists through the SARAH exercise programme
with detailed descriptions of the different elements. Whilst patients
are welcome to have a look at this, the next step is for the team to
work on how the exercise programme can be implemented into clinical
practice and for patients to have easy access to this treatment.
Over 450 patients from 17 NHS trusts were part of the Strengthening
And Stretching For Rheumatoid Arthritis of the Hand (SARAH) trial. All
people who entered the trial received joint protection advice, with half
of all people in the study also undertaking the daily exercise
programme for the hands and arms.
The SARAH trial was funded by the National Institute of Health
Research Health Technology Assessment Programme (NIHR HTA), project
number 07/32/05 and was a collaboration between several higher education
institutions (University of Warwick, University of Oxford, University
of Southampton, Brunel University and University College London).