Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network hand exercise program (SPIN-HAND): study protocol



Significant functional impairment of the hands is nearly universal in systemic sclerosis (SSc, scleroderma). Hand exercises may improve hand function, but developing, testing and disseminating rehabilitation interventions in SSc is challenging. The Scleroderma Patient-centered Intervention Network (SPIN) was established to address this issue and has developed an online hand exercise program to improve hand function for SSc patients (SPIN-HAND). The aim of the proposed feasibility trial is to evaluate the feasibility of conducting a full-scale randomized controlled trial (RCT) of the SPIN-HAND intervention.

Design and methods

The SPIN-HAND feasibility trial will be conducted via the SPIN Cohort. The SPIN Cohort was developed as a framework for embedded pragmatic trials using the cohort multiple RCT design. In total, 40 English-speaking SPIN Cohort participants with at least mild hand function limitations (Cochin Hand Function Scale ≥3) and an indicated interest in using an online hand-exercise intervention will be randomized with a 1:1 ratio to be offered to use the SPIN-HAND program or usual care for 3 months. The primary aim is to evaluate the trial implementation processes, required resources and management, scientific aspects, and participant acceptability and usage of the SPIN-HAND program.


The SPIN-HAND exercise program is a self-help tool that may improve hand function in patients with SSc. The SPIN-HAND feasibility trial will ensure that trial methodology is robust, feasible, and consistent with trial participant expectations. The results will guide adjustments that need to be implemented before undertaking a full-scale RCT of the SPIN-HAND program.

Trial registration Identifier: NCT03092024.

Post author correction




Marie-Eve Carrier, Linda Kwakkenbos, Isabelle Boutron, Joep Welling, Maureen Sauve, Cornelia van den Ende, Anne A. Schouffoer, Marie Hudson, Brett D. Thombs, Luc Mouthon, SPIN Investigators

Article History


Financial support: SPIN, including the present feasibility trial, has been funded by grants from the Canadian Institutes of Health Research (TR3-119192, PJT-148504, PJT-149073) and the Arthritis Society. In addition, SPIN has received institutional contributions from the Lady Davis Institute for Medical Research of the Jewish General Hospital, Montreal, Canada and from McGill University, Montreal, Canada. SPIN has also received support from the Scleroderma Society of Ontario, Scleroderma Canada, and Sclérodermie Québec. Dr. Kwakkenbos was supported by a CIHR Banting Postdoctoral Fellowship. Dr. Thombs was supported by a Fonds de recherche du Québec - Santé (FRQS) researcher salary award.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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  • Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec - Canada
  • Department of Psychiatry, McGill University, Montreal, Quebec - Canada
  • Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen - The Netherlands
  • Université Paris Descartes, Paris - France
  • Assistance Publique-Hôpitaux de Paris, Paris - France
  • NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht - The Netherlands
  • Scleroderma Society of Ontario, Hamilton, Ontario - Canada
  • Scleroderma Canada, Ottawa, Ontario - Canada
  • Sint Maartenskliniek, Nijmegen - The Netherlands
  • Leiden University Medical Center, Leiden - The Netherlands
  • Department of Medicine, McGill University, Montréal, Québec - Canada
  • Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec - Canada
  • Department of Psychology, McGill University, Montréal, Québec - Canada
  • Department of Educational and Counselling Psychology, McGill University, Montréal, Québec - Canada
  • Service de Médecine Interne, Hôpital Cochin, Paris - France
  • The complete list of SPIN investigators is available in the Acknowledgements section.

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