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Rheumatoid arthritis is a chronic inflammatory joint disease frequently involving joints of the hands and wrists. Hand exercises play an integral part in the rehabilitation of people with hand problems due to rheumatoid arthritis.

We developed a tailored, progressive hand exercise programme called Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH) programme which was found to be a clinically and cost- effective in improving hand function and quality of life in a large clinical trial involving people with rheumatoid arthritis. 

The SARAH programme is now recommended in the NICE guidelines for management of rheumatoid arthritis in adults.

With high-quality evidence now available for the effectiveness of the SARAH programme, it is important that it is translated into routine NHS care to ensure evidence-based practice and help improve patient outcomes. 

Implementing evidence into practice is challenging, particularly when it requires learning new skills and a change in clinical practice. In order to support clinicians to adopt and correctly apply the SARAH exercise programme into their daily practice, we have designed an online training on the SARAH programme (iSARAH) for NHS physiotherapists and occupational therapists. 

We have also developed the online SARAH programme for patients to access the SARAH exercises from home (mySARAH). We are conducting a proof-of-concept study before rolling this out on a wider level.

Our SARAH implementation work is funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford and supported by the NIHR Biomedical Research Centre.

NIHR Funded by Feb2019