mySARAH Proof-of-concept study
Research type
Research Study
Full title
A web-based hand exercise programme (mySARAH) for people with rheumatoid arthritis: Proof-of-Concept study
IRAS ID
237807
Contact name
Esther Williamson
Contact email
Sponsor organisation
Clinical Trials and Research Governance
Duration of Study in the UK
0 years, 9 months, 0 days
Research summary
The SARAH (Strengthening And Stretching for Rheumatoid Arthritis of the Hand) programme is for people with rheumatoid arthritis (RA) affecting their hands. It includes 11 exercises for the hands, wrists and arms. The programme was tested in a large study and has been shown to improve hand function and it is cost-effective. The programme is recommended by NICE. We want to make this programme accessible to people with RA. We have developed the mySARAH website so people with RA can log into the website and do the SARAH programme themselves rather than having to attend hospital appointments. This proof-of-concept study aims to test the acceptability and feasibility of the mySARAH programme and to monitor the impact on symptoms in a small group of participants. We need to make sure that people are able to work through the programme and carry out the exercises correctly and safely. The programme is made up of 6 online sessions which are completed over 12 weeks. Participants are asked to complete daily exercises. It uses videos, written text and diagrams to teach participants the exercises and includes strategies to help them stay motivated including an online exercise diary, goal setting and exercise planning. During the study, 12 participants will work through the 6 online sessions. They will be observed during 4 sessions by a researcher. We will film participants doing the exercises so we can check they are done correctly. They will complete 2 sessions independently. Baseline measurements include disability and hand grip strength. On completion we will collect disability, strength and global rating of change. We will monitor symptoms and adverse events. One month after completing mySARAH, Participants will be invited to participate in a telephone interview to discuss their experiences and complete a short questionnaire measuring the impact on their hand RA.
Summary of Results:
Introduction The Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH) program is 12-week hand and arm exercise program recommended in the National Institute for Health and Care Excellence guidelines. It includes seven range of motion exercises and four strength exercises against resistance. An online version of the SARAH program (mySARAH) was developed to allow people with rheumatoid arthritis to teach them the SARAH exercises.
Purpose
The purpose of this study was to assess if people with RA could successfully access and follow the online course, to measure outcomes (hand function, grip strength) and to talk to them about their experiences of using the online programme.
Methods
mySARAH is a self-guided, online version of the SARAH program with six exercise training and review sessions. Researchers observed participants 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 call was conducted to talk to participants about their experiences with mySARAH. We also asked them rate their hand pain and function.Results:
Eleven participants (males/females: 3/8) with an average age of 63 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
Our study showed that mySARAH was easy to access, could be successfully completed by people with RA and they found it beneficial. Feedback from participants will allow us to improve the programme before carrying out further testing and making it widely available.REC name
South Central - Berkshire B Research Ethics Committee
REC reference
18/SC/0070
Date of REC Opinion
21 Feb 2018
REC opinion
Favourable Opinion