Fit & Strong! has improved function among people with arthritis.
A randomized controlled trial compared the effects of participation in Fit & Strong! (N = 115) to a control group (N = 110) at baseline, two, six, and twelve months following randomization.
Relative to the control group, Fit & Strong! participants experienced statistically significant improvements at two months (end of formal program) in their
- confidence in their ability to exercise safely with arthritis
- participation in exercise, and
- lower extremity stiffness
These benefits were maintained at six months at which time participants also experienced the additional significant benefits of increased confidence in their ability to adhere to exercise over time, a significant decrease in lower extremity joint pain, and a marginally significant increase in their confidence in their ability to manage arthritis pain.
At 12 months, significant treatment group effects were maintained on confidence to exercise safely with arthritis and continued exercise participation that were accompanied by marginally significant reductions in lower extremity stiffness and pain. No adverse health effects were seen.
Although Fit & Strong! ends at 2 months, effect sizes for self-efficacy for exercise and for exercise adherence at 6 and 12 months in the treatment group were large, at 0.798 and 0.713, and 0.905 and 0.669, respectively. Furthermore, treatment group participants maintained a 56% increase in participation in physical activity relative to their baseline levels at 12 months. This rate is approximately double the rate observed among control group members at twelve months. These findings indicate that Fit & Strong! has demonstrated substantial efficacy.
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A large effectiveness trial with approximately 500 participants found substantial maintenance of treatment effects for Fit & Strong! out to 18 months. We examined pre/posttest outcomes following participation in the 8-week Fit & Strong! program at baseline, 2, 6, 12 and 18 months. The study found significant increases in participation in physical activity at two months that were maintained at 18 months. This sustained increase in physical activity was accompanied by maintenance of significant improvements in:
- Lower extremity joint stiffness
- Lower extremity pain and function
- Lower extremity strength (timed-stands test)
- Mobility (6 minute distance walk)
- Anxiety and depression over the same time period
These results matter because lower extremity strength and mobility are both risk factors for falls, and mobility is also an independent risk factor for mortality (Sherrington et al., 2008; Studenski et al., 2011). Further, walking speed is known to decrease 12-16% per decade for persons 62 years of age and older (Himann et al., 2009). Our high risk population showed sustained increases over 18 months
This research was funded by:
P30 Midwest Roybal Center For Health Promotion & Behavior Change (AG022849))
National Institute on Aging Midwest Roybal Center for Health Maintenance (P50AG15890)