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Hand exercises for patients with rheumatoid arthritis : an extended follow-up of the SARAH randomised controlled trial.

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Williamson, Esther, McConkey, Christopher C., Heine, Peter, Dosanjh, Sukhdeep, Williams, Mark and Lamb, S. E. (Sallie E.) (2017) Hand exercises for patients with rheumatoid arthritis : an extended follow-up of the SARAH randomised controlled trial. BMJ Open, 7 (4). e013121. doi:10.1136/bmjopen-2016-013121 ISSN 2044-6055.

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Official URL: http://dx.doi.org/10.1136/bmjopen-2016-013121

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Abstract

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. 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. 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. 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. ISRCTN89936343; Results. [Abstract copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.]

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 12 April 2017
Dates:
DateEvent
12 April 2017Published
13 December 2016Accepted
Volume: 7
Number: 4
Article Number: e013121
DOI: 10.1136/bmjopen-2016-013121
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): ** From PubMed via Jisc Publications Router.
Access rights to Published version: Open Access (Creative Commons)

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