Effects of the remote video-based SARAH program in individuals with rheumatoid arthritis: A randomized controlled single-blinded study

Introduction To investigate the effectiveness of the remote video-based Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) exercise program in individuals with rheumatoid arthritis (RA) with wrist involvement. Methods Seventy-three individuals were included in the study. Wrist joint position sense, wrist joint range of motion, wrist pain, wrist morning stiffness, subjective and objective hand function, grip strength, and disease-related health status were assessed at baseline and after 12 weeks. Following the baseline assessment, participants were randomly assigned into two groups as SARAH and Control. All participants maintained their pharmacological therapy. The SARAH group received SARAH exercise videos via a free messaging platform (WhatsApp Messenger) weekly and performed the program daily for 12 weeks. No additional intervention was provided to the control group. Results Forty-nine individuals (SARAH group = 28, control group = 21) completed all study procedures. Both per-protocol and intention-to-treat (ITT) analyses showed significant improvements in all parameters in the SARAH group ( p < 0.05), while no statistically significant changes were detected in the control group ( p > 0.05). When the changes were compared between the groups, SARAH group showed greater improvements regarding the changes in wrist joint position sense, wrist flexion, extension (only in ITT analysis) and radial deviation joint range of motion, wrist pain, wrist morning stiffness duration (only in ITT analysis), hand function, grip strength, and disease-related health status compared to the control group ( p < 0.05). Discussion A 12-week remote video-based SARAH exercise program provides additional benefits in individuals with RA who present wrist related problems when added to pharmacological therapy.