Exercise Adherence Among Older Adults With Osteoarthritis

• Maintenance of exercise behavior measured by CHAMPS (Community Healthy Activities Model Program For Seniors) [ Time Frame: Baseline, 2 months, 6 months, 12 months, 18 months ] [ Designated as safety issue: No ]
  

• Changes in lower extremity strength (timed sit-stand test) [ Time Frame: Baseline, 2 months, 6 months, 12 months, 18 months ] [ Designated as safety issue: No ]
  
• Aerobic capacity (6 minute distance walk) [ Time Frame: Baseline, 2 months, 6 months, 12 months, 18 months ] [ Designated as safety issue: No ]
  
• Pain, stiffness, physical function subscales measured by WOMAC (Western Ontario and McMaster osteoarthritis index) [ Time Frame: Baseline, 2 months, 6 months, 12 months, 18 months ] [ Designated as safety issue: No ]
  
• Functional ability measured by GeriAIMS (Geriatric Arthritis Impact Measurement Scale) [ Time Frame: Baseline, 2 months, 6 months, 12 months, 18 months ] [ Designated as safety issue: No ]
  

Osteoarthritis (OA) is the most common condition affecting older people today. It is the leading cause of disability among older people and its impact is projected to increase substantially with the aging of the U.S population from 43 million currently to 60 million by 2020.

Promising 2- and 6-month outcomes have recently been reported from a randomized trial of a multi-component exercise intervention targeted at older adults with lower extremity OA. The Fit and Strong intervention, developed and tested as part of the Midwest Roybal Center for Health Maintenance, coupled strength training and aerobic walking with health education for sustained behavior change. Improvements have been found in confidence in ability to exercise, confidence in ability to continue exercising over time, lower extremity stiffness, lower extremity pain, and 6-minute distance walk. Importantly, the average adherence rate in the people who participated in the exercise intervention at six months was twice that reported by controls.

The specific aims of this study are to use a multi-site randomized controlled clinical trial to replicate the Fit and Strong intervention and to test the comparative effectiveness of a negotiated/tailored follow-up maintenance strategy vs. a mainstreaming, facility-based maintenance strategy, both of which will be tested with and without telephone reinforcement as an enhancement.

All enrolled participants will participate in the 8-week Fit and Strong exercise program designed specifically for older adults with lower-extremity OA. Prior to the conclusion of Fit and Strong participants will be randomly assigned to one of two follow-up maintenance groups. There is no more than minimal risk associated with this program.