PT Pintcast - Physical Therapy

PT Pintcast - Physical Therapy

Research Review of SARAH from PEDro

January 27, 2020

PEDro stands for Physiotherapy Evidence Database, 

It’s a free database of over 45,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy. 

For each trial, review or guideline, PEDro provides the citation details, the abstract and a link to the full text, where possible. 

All trials on PEDro are independently assessed for quality. 

These quality ratings are used to quickly guide users to trials that are more likely to be valid and to contain sufficient information to guide clinical practice. 

PEDro is produced by the Institute for Musculoskeletal Health, School of Public Health at the University of Sydney and is hosted by Neuroscience Research Australia.

And did we mention… this is free?!  Find PEDro at

Now To celebrate PEDro’s 20th birthday they’ve have identified the five most important randomised controlled trials in physiotherapy published in the last 5 years. These trials were nominated by PEDro users, and an independent panel of international trialists judged the nominations received.

Now YOU get to take advantage of hearing a little more about these standout pieces of work… by the people who created them.

In this episode we talk to Professor for Health Innovation at the University of Exeter Sallie Lamb about SARAH, or Strengthening and Stretching for Rheumatoid Arthritis of the Hand Trial (SARAH) Trial Team

It appeared in Lancet 2015 Jan 31;385(9966):421-429.

More about Sallie Lamb. Sallie has a long-standing interest in clinical trials, medical statistics and, rehabilitation of musculoskeletal and chronic conditions in older people. She works with clinicians to develop pragmatic clinical trial designs to capture the effectiveness and cost-effectiveness of a variety of health interventions. She is the Chief Investigator for a number of trials of rehabilitation interventions. 

Disease-modifying biological agents and other drug regimens have substantially improved control of disease activity and joint damage in people with rheumatoid arthritis of the hand. However, commensurate changes in function and quality of life are not always noted. Tailored hand exercises might provide additional improvements, but evidence is lacking. We estimated the effectiveness and cost-effectiveness of tailored hand exercises in addition to usual care during 12 months. 

We have shown that a tailored hand exercise program is a worthwhile, low-cost intervention to provide as an adjunct to various drug regimens. Maximisation of the benefits of biological and DMARD regimens in terms of function, disability, and health-related quality of life should be an important treatment aim.

Improvements in overall hand function were 36 points (95% CI 15 to 57) in the usual care group and 79 points (60 to 99) in the exercise group (mean difference between groups 43, 95% CI 15 to 71; p = 0.0028).

Pain, drug regimens, and health-care resource use were stable for 12 months, with no difference between the groups.