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The Gerontologist 46:801-814 (2006)
© 2006 The Gerontological Society of America

Long-Term Impact of Fit and Strong! on Older Adults With Osteoarthritis

Susan L. Hughes, DSW1, Rachel B. Seymour, PhD1, Richard T. Campbell, PhD1, Gail Huber, PhD, PT, MHPE2, Naomi Pollak, MS, PT3, Leena Sharma, MD4 and Pankaja Desai, MPH, MSW1

Correspondence: Address correspondence to Susan L. Hughes, DSW, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, Room 558, Chicago, IL 60608. E-mail:shughes{at}uic.edu

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 =.001), minutes of exercise per week (p =.000), and lower extremity stiffness (p =.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 =.001), reduced pain (p =.040), and a marginally significant increase in self-efficacy for arthritis pain management (p =.052). Despite a substantially smaller sample size at 12 months, significant treatment-group effects were maintained on self-efficacy for exercise (p =.006) and minutes of exercise per week (p =.001), accompanied by marginally significant reductions in lower extremity stiffness (p =.056) and pain (p =.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.

Key Words: Arthritis • Exercise • Outcomes • Physical activity • Self-efficacy






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