RA Track
GRIP Maternal
Duration
3 phases · Pre-Conception (≥3 mo), Pregnancy, Postpartum
Structure
Trimester-specific, companion to GRIP
Delivery
Virtual
About this protocol
GRIP Maternal is the reproductive-continuum companion to GRIP. The PreCARA study (2021) demonstrated 90.4% low disease activity or remission by the third trimester with modern treat-to-target care, while postpartum flares occur in 46.7% of patients within three months. The module integrates EULAR/BSR drug guidelines, ACOG Committee Opinion 804, and the 2019 Canadian Physical Activity in Pregnancy Guidelines — targeting methotrexate cessation 1–3 months pre-conception, certolizumab-friendly programming through pregnancy, and prompt postpartum exercise restart to combat the high-risk flare window.
Clinical authors
- Angelo Papachristos, PT, ACPAC
- Sameer Chunara, PT, ACPAC
Evidence base
GRIP Maternal is derived from systematic review and randomized controlled trial evidence in RA — Pre-Conception, Pregnancy & Postpartum. Protocol parameters — phase structure, load progression, and outcome measures — align with EULAR, ACR, and ASAS exercise-therapy recommendations. Outcome tracking favours open-access PROMIS instruments where validated equivalents exist.
View the evidence library →Outcome measures
- All GRIP core measures (PROMIS swaps applied)PROMIS
- DAS28-CRP at 6 weeks postpartum (flare monitoring)
- Grip strength (infant care demands)
- Diastasis recti assessment at 6 weeks postpartum
- DXA body composition at 6 months postpartum
PROMIS short forms are free, NIH-developed measures used in place of paid legacy instruments.
What's included
- Virtual assessment with a certified exercise therapist
- Personalised programme plan
- Live-virtual group or individual sessions
- Asynchronous guided home programme
- Regular ePRO check-ins with adaptive progression
- Care coordinator support
- Programme completion report
Interested in this protocol?
Speak to us about adding GRIP Maternal to your PSP or benefits plan.
Request a pilotFor patients