11 Jun Meet SARAH: Your helping hand with rheumatoid arthritis
Do you have rheumatoid arthritis? If you do, or know someone who does, you may be interested to know that there is a new evidence-based exercise program called SARAH, which has been shown to improve hand function and reduce pain. This program is quick, easy and effective, but more on that later. First, let’s start at the basics.
Rheumatoid arthritis is an autoimmune condition where the body’s own immune cells destroy healthy joint tissue, resulting in inflamed and sore joints. Most commonly, the smaller joints of the body such as those in the hands and feet are affected, however other larger joints such as knee and hip joints can be affected too. This condition can have a big impact on how we use our hands, and ultimately on how we function day-to-day.
How can you treat rheumatoid arthritis?
Unfortunately, there is no cure for rheumatoid arthritis, however the management of the condition can be effective in reducing pain and improving hand function. Currently, the typical treatment for rheumatoid arthritis is having a good rheumatologist and medication list, combined with a healthy lifestyle and strategies to help keep symptoms at bay such as joint protection principles and taking rest breaks. Hydrotherapy and adapted tools and equipment commonly prescribed by occupational therapists can also relieve symptoms significantly.
In regards to hand therapy, there are a number of strategies we can implement to manage rheumatoid arthritis such as splinting to improve pain and manage deformity, as well as exercises, heat and cold therapies, and activity modification recommendations. These are all important and effective ways of managing the condition.
Who/what is SARAH?
SARAH stands for Strengthening And stretching for Rheumatoid Arthritis of the Hand, and is a relatively new program. The program includes 11 simple exercises for the fingers, wrist and shoulder; 7 involve movement and 4 involve strengthening. The reasoning behind moving joints is relatively simple: “motion is lotion”. Motion provides the joint with lubrication of joint fluid, and helps prevent stiffness and pain.
The reasoning behind strengthening is to stabilise the affected joints through the muscles surrounding the joints. When we think of joint stability, we often think that ligaments are the sole structures ensuring that joints are stable. However, muscles play a big role in ensuring stable joints.
If you are concerned that exercise worsens your symptoms, then here is some good news. Research shows that exercise improves general muscular endurance and strength without negative effects on pain or disease progression for those with rheumatoid arthritis.
Why is SARAH important?
A recent randomised controlled trial (RCT) study completed in 2015 compared the outcomes of those who received standard care (joint protection principle education and functional splinting) to those who received both standard care and SARAH. Those who received SARAH completed the program daily for 12 weeks, and were encouraged to continue this down the track.
At both the 4 and 12 month mark, those who completed SARAH in addition to usual care reported improved hand function and had better measures of grip and pinch strength. In addition, most participants found they had improved self-efficacy, or empowerment, over managing their rheumatoid arthritis. The authors concluded that SARAH is a beneficial, low-cost program when used in conjunction with medications for people with rheumatoid arthritis.
You can meet SARAH at any Melbourne Hand Rehab clinic to help manage your rheumatoid arthritis today! Call 03 9458 5166
For more information on rheumatoid arthritis, and other types of arthritis, Arthritis Australia is a good online resource.BOOK ONLINE
Williams, M. A., Williamson, E. M., Heine, P. J., Nichols, V., Glover, M. J., Dritsaki M., Adams J., … Lamb, S. E. (2015). Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomised controlled trial and economic evaluation. Health Technology Assessment, 19(19), 1-222. doi: 10.3310/hta19190.