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Health Sciences

Global top five for Physiotherapy research involving Southampton professor

Published: 5 November 2019
Professor Jo Adams

A Southampton occupational therapy expert has been recognised for her part in an innovative trial that is improving the lives of people with hand and upper limb rheumatoid arthritis (RA) across the UK.

Professor of Musculoskeletal Health, Jo Adams, is part of a team of academics and clinical NHS staff whose research – the SARAH programme - has been named as one of the world’s top five papers from the last five years by the Physiotherapy Evidence Database (PEDro).

PEDro is a free database of more than 44,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy and to celebrate their 20th anniversary they identified five of the most important physiotherapy randomised controlled trials that have been published between 2014 and 2019. The top five were selected by an international panel of physiotherapy clinical trialists as it was felt they had answered important clinical questions in a robust and innovative way.

The SARAH research programme focused on strengthening and stretching for RA of the hand, and brought academics from Southampton, Warwick, Oxford and University College London, together with physiotherapists and occupational therapists from 17 NHS Trusts.

The team designed and developed an exercise programme for patients with RA in their hands that included specific strategies to increase motivation and adherence to the programme including a specific commitment from the participants to carry out exercises in their own homes.

Outpatient treatments were provided to 480 patients with painful and problematic RA hands.  All participants received best practice usual care including joint protection advice, general exercise advice, functional splinting and assistive devices; but half of the group also received an additional individualised exercise programme of strengthening and stretching exercises.

The research findings showed that the addition of the exercise regime delivered by an experienced therapist was more effective in restoring and retaining hand function in RA, and had a positive effect on the daily living, work and physical and emotional roles of the participants than best practice usual care. It also showed that the enhanced programme was cost-effective for the NHS.

Jo said: “The team is thrilled with the recognition of being named as one of the top five research papers in the world by PEDro. SARAH builds on previous research that was carried out to accurately measure hand function in RA and the impact of ‘self-management’ strategies for patients. This new research used resistive and stretching exercises to treat painful RA hands and the findings were published in the Lancet.

“Southampton students immediately benefited from this research. I was teaching our occupational therapy and physiotherapy students, alongside being part of the team delivering this national trial, which meant our students were getting direct access to state-of-the-art evidence based teaching around research relating to contemporary national trials. The results of the trial were being reflected straight back into the teaching of our next generation of occupational therapists and physiotherapists.”

The exercise programme, developed as part of the SARH programme, is now freely available to all NHS therapists across the UK for their treatment of patients with painful RA hands, and a web-based resource has been developed to make the programme more accessible to a wide range of people living with painful RA hands. The trial’s findings also contribute to NICE guidelines.

Involvement with such a prestigious trial highlights the standard of the Physiotherapy and Occupational Therapy team at Southampton, a fact also reflected in both professional subjects being ranked as first in the UK by the Complete University Guide, 2020.

The SARAH programme was funded by the National Institute for Health Research Health Technology Assessment Programme.

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