Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Fit and Strong!: Bolstering Maintenance of Physical Activity among Older Adults with Lower-Extremity Osteoarthritis.

Hughes4,  Susan L., Seymour4,  Rachel B., Campbell3,  Richard T., Desai3,  Pankaja, Huber2,  Gail, Chang1,  Justina

JAMA
Northwestern University
University of Illinois Chicago
University of Illinois Chicago, Chicago, IL

Osteoarthritis (OA) is the most common condition affecting older people today. Lower extremity joint impairment caused by osteoarthritis has been shown to be a risk factor for future disability. Physical activity (PA) has been shown to play a critical role in the amelioration of symptoms and progress of the disease. However, little is known about effective ways of motivating older adults to maintain PA after a formal training program ends. Fit and Strong! is an award winning, evidence-based multiple-component PA/behavior change program for older adults with lower-extremity (LE) OA. This study used a multi-site comparative effectiveness trial (N=486) with repeated measures to compare the impact of negotiated vs. mainstreamed follow-up with and without telephone reinforcement (TR) on maintenance of PA after the 8-week Fit and Strong! program ends. Random effects analyses for the total sample showed significant pre-post improvements at 2,6,12, and 18 months on PA maintenance that were accompanied by significant improvements in LE pain and stiffness, LE function, sit-stand, and 6-minute distance walk and anxiety and anxiety/depression. Analyses by treatment condition showed that persons in the negotiated group who received TR maintained a 21% increase in caloric expenditures over baseline, with lesser benefits seen in the negotiated only, mainstreamed with TR, and mainstreamed only groups. Significant benefits of telephone dose were also seen on lower-extremity joint stiffness, pain, and function as well as anxiety and anxiety/depression. The negotiated follow-up contract that Fit and Strong! uses, bolstered by TR, is associated with enhanced long-term PA maintenance and associated health outcomes. While TR was effective, it is not inexpensive, which may impede its translation and dissemination into community-based settings. Other forms of reinforcement, like participant and instructor videos will also be important to test if we are to maximize the successful translation of evidence-based programs in the future.

To cite this abstract, please use the following information:
Hughes, Susan L., Seymour, Rachel B., Campbell, Richard T., Desai, Pankaja, Huber, Gail, Chang, Justina; Fit and Strong!: Bolstering Maintenance of Physical Activity among Older Adults with Lower-Extremity Osteoarthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :692
DOI: 10.1002/art.28460

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