The Gerontologist Copyright 2004 by The Gerontological Society of America Vol. 44, No. 2, 217–228 Impact of the Fit and Strong Intervention on Older Adults With Osteoarthritis Susan L. Hughes, DSW, 1 Rachel B. Seymour, MS, 1 Richard Campbell, PhD, 1 Naomi Pollak, MS, PT, 1 Gail Huber, MHPE, PT, 2 and Leena Sharma, MD 3 Purpose: This study assessed the impact of a low cost, multicomponent physical activity intervention for older adults with lower extremity osteoarthritis. De- sign and Methods: A randomized controlled trial compared the effects of a facility-based multiple- component training program followed by home- based adherence (n ¼ 80) to a wait list control group (n ¼ 70). Assessments were conducted at baseline and at 2 and 6 months following randomization. The training program consisted of range of motion, resistance training, aerobic walking, and educa- tion–group problem solving regarding self-efficacy for exercise and exercise adherence. All training group participants developed individualized plans for posttraining adherence. Results: Relative to the persons in the control group, individuals who participated in the exercise program experienced a statistically significant improvement in exercise efficacy, a 48.5% increase in exercise adherence, and a 13.3% increase in 6-min distance walk that were accompanied by significant decreases in lower extremity stiffness at 2 and 6 months. Program participants also experienced a significant decrease in lower extremity pain and a borderline significant improvement in efficacy to adhere to exercise over time at 6 months (p ¼ .052). In contrast, persons in the control group deteriorated over time on the efficacy and adherence measures and showed no change on the other measures. No adverse health effects were encountered. Implications: These benefits indicate that this low-cost intervention may hold great promise as one of a growing number of public health intervention strategies for older adults in the United States with osteoarthritis. Key Words: Arthritis, Elderly, Clinical trial, Out- comes Osteoarthritis (OA) is the most common condition affecting older people today. It is a major cause of disability among older people and its impact is projected to increase with the aging of the U.S population from the current level of 43 million to 60 million by 2020 (Centers for Disease Control, 1999). Lower extremity OA, in particular, has been shown to be a risk factor for disability and institutionalization (Dunlop, Hughes, and Manheim, 1997; Guralnik, Ferrucci, Simonsick, Salive, & Wallace, 1995; Jette et al., 1999). OA is known to be painful and to cause limitation of mobility, as persons with OA minimize movement in order to reduce their exposure to pain. Comparisons of persons with and without OA have shown that, as a result of this reduced mobility, the condition is associated with both reduced lower extremity strength and reduced aerobic functioning (Minor, Hewett, Weber, Anderson, & Kay, 1989; Semble, Loeser, & Wise, 1990). Possibly because of increased pain and decreased mobility, persons with OA also experience depression and may become socially isolated (Blixen & Kippes, 1999). Given the substantial public health significance of OA, several exercise interventions have been de- veloped and tested among older persons with this condition over the past 20 years (Chamberlain, Care, & Harfield, 1982; Ettinger et al., 1997; Fisher, Pendergast, Gresham, & Calkins, 1991; Kovar et al., 1992; Minor et al., 1989). Three early single-group pretest–posttest studies of strengthening exercises found significant short-term treatment group im- provements in knee flexor and extensor strength (Chamberlain et al., 1982; Kreindler et al., 1989; The development of Fit and Strong was made possible by a grant from the Chicago Chapter of the Arthritis Foundation. The research was also supported by funding from the National Institute on Arthritis and Musculoskeletal Disease (Grant AR30692) and by the National Institute on Aging and the Roybal Center for Research on Applied Gerontology (Grant AG 15890). We express our appreciation to the multiple sites in Evanston and Chicago that have hosted the Fit and Strong Intervention, and to the two anonymous reviewers of the manuscript for their insightful comments. Address correspondence to Susan L. Hughes, DSW, Health Research and Policy Centers, University of Illinois at Chicago, 850 W. Jackson Blvd., Suite 400, Chicago, IL 60607. E-mail: shughes@uic.edu 1 Health Research & Policy Centers, University of Illinois at Chicago. 2 Programs in Physical Therapy, Northwestern University, Chicago, IL. 3 Arthritis Division, Northwestern University, Chicago, IL. Vol. 44, No. 2, 2004 217 by guest on November 13, 2015 http://gerontologist.oxfordjournals.org/ Downloaded from