Work

Short-Term Results of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)-Intensive Protocol for Hospitalized Patients With Rheumatoid Arthritis

Year: 2026

Type: article

Abstract: BACKGROUND: Advancements in pharmacotherapy have driven a paradigm shift in rheumatoid arthritis (RA) management, subsequently transitioning rehabilitation goals from passive pain control toward proactive functional improvement. This embodies a "rehabilitation treat-to-target (RT2T)" approach. While the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is an evidence-based self-management regimen, its application in acute inpatient settings remains underexplored. This study aimed to evaluate the short-term effectiveness of an adapted, intensive inpatient version of this program (SARAH-Intensive Protocol (SARAH-IP)). METHODS: This study evaluated 21 hospitalized patients with RA (mean age 69.0 years) prospectively who underwent the SARAH-IP during admission, primarily following orthopedic surgery or systemic medication initiation, at the Department of Orthopaedic Surgery & Rehabilitation, Yamagata University Faculty of Medicine, Japan. The SARAH-IP involved therapist-guided functional training five times weekly, strategically supplemented by patient-led weekend self-exercises and continuous structured feedback. Primary outcomes, including grip strength (dominant and non-dominant) and Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) scores, were assessed at baseline and discharge. RESULTS: The SARAH-IP group achieved an overall 20/21 (95%) improvement rate in grip strength and Q-DASH scores, translating directly to enhanced activities of daily living (ADL). Crucially, the SARAH-IP cohort exhibited significant bilateral enhancements. CONCLUSIONS: The SARAH-IP is an effective short-term inpatient rehabilitation strategy for RA, conferring comprehensive functional benefits to both dominant and non-dominant upper extremities. By integrating continuous therapist feedback with self-managed exercises, this intensive protocol effectively bridges inpatient intervention with post-discharge self-care. Future research should evaluate the long-term adherence and efficacy of this regimen in broader patient populations.

Source: Cureus

DOI: 10.7759/cureus.116831