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Long-term impact of fit and strong! On older adults with osteoarthritis |
Hughes SL, Seymour RB, Campbell RT, Huber G, Pollak N, Sharma L, Desai P |
The Gerontologist 2006 Dec;46(6):801-814 |
clinical trial |
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
PURPOSE: We present final outcomes from the multiple-component Fit and Strong! intervention for older adults with lower extremity osteoarthritis. DESIGN AND METHODS: A randomized controlled trial compared the effects of this exercise and behavior-change program followed by home-based reinforcement (n = 115) with a wait list control (n = 100) at 2, 6, and 12 months. Fit and Strong! combined flexibility, aerobic walking, and resistance training with education and group problem solving to enhance self-efficacy for exercise and maintenance of physical activity. All participants developed individualized plans for long-term maintenance. RESULTS: Relative to controls, treatment participants experienced statistically significant improvements in self-efficacy for exercise (p = 0.001), minutes of exercise per week (p = 0.000), and lower extremity stiffness (p = 0.018) at 2 months. These benefits were maintained at 6 months and were accompanied by increased self-efficacy for adherence to exercise over time (p = 0.001), reduced pain (p = 0.040), and a marginally significant increase in self-efficacy for arthritis pain management (p = 0.052). Despite a substantially smaller sample size at 12 months, significant treatment-group effects were maintained on self-efficacy for exercise (p = 0.006) and minutes of exercise per week (p = 0.001), accompanied by marginally significant reductions in lower extremity stiffness (p = 0.056) and pain (p = 0.066). No adverse health effects were seen. Effect sizes for self-efficacy for exercise and for maintenance of physical activity were 0.798 and 0.713, and 0.905 and 0.669, respectively, in the treatment group at 6 and 12 months. IMPLICATIONS: This consistent pattern of benefits indicates that this low-cost intervention is efficacious for older adults with lower extremity osteoarthritis.
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