title: A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study.
abstract: OBJECTIVE
  To determine whether a home-based pedometer-driven walking program with arthritis self-management education (Walk +) would increase physical activity, muscle strength, and functional performance in older adults with osteoarthritis (OA) of the knee as opposed to arthritis self-management education alone (EDU).
  
  
  METHODS
  A randomized two-by-three (group-by-time) design with participants assigned to Walk + (n = 17, mean age +/- standard deviation = 69.6 +/- 6.7) or EDU (n = 17, age = 70.8 +/- 4.7).
  
  
  METHODS
  Community located in the Baltimore-Washington area.
  
  
  METHODS
  Thirty-four community-dwelling adults, aged 60 and older with symptomatic knee OA and self-reported functional impairment.
  
  
  METHODS
  Both groups received 12 hours of the Arthritis Self-Management program over 12 weeks and were followed for an additional 12 weeks. In addition, the Walk + group received individualized instruction in the use of a pedometer, with the goal of increasing their step count by 30% of their baseline step count.
  
  
  METHODS
  The outcome measures were physical activity (daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac-R3D accelerometer), quadriceps femoris strength (isometric peak torque), and functional performance tasks (100-foot walk-turn-walk, timed stair climb, timed chair rise, and pain status).
  
  
  RESULTS
  Daily steps walked showed a significant group-by-time interaction (P =.04) after controlling for age. From baseline to completion of training, a 23% increase in daily steps occurred in the Walk + group and a 15% decrease in the EDU group. Although steps increased in the Walk + group, total activity vector magnitude was maintained, suggesting a more efficient gait. The Walk + group became quicker than the EDU group in the normal-pace walk-turn-walk (P =.04). An isometric strength gain of 21% postintervention was seen in the Walk + group, compared with a loss of 3.5% in the EDU group.
  
  
  CONCLUSIONS
  In older adults with symptomatic knee OA, Walk + appears to increase walking, with improvements in muscle strength and walking performance. The use of a home-based pedometer-driven program to increase physical activity, strength, and function in this population warrants further research.
authors.affiliation: Johns Hopkins University, School of Nursing, 525 North Wolfe Street, Rm. 445, Baltimore, MD 21205, USA. ltalbot@son.jhmi.edu
authors.forename: Laura A
authors.initials: LA
authors.lastname: Talbot
authors.forename: Jean M
authors.initials: JM
authors.lastname: Gaines
authors.forename: Tu N
authors.initials: TN
authors.lastname: Huynh
authors.forename: E Jeffrey
authors.initials: EJ
authors.lastname: Metter
mesh_terms: D000368:Aged; D015142:Baltimore; D004219:District of Columbia; D005081:Exercise Therapy; D005260:Female; D006293:Health Promotion; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000628:therapy*; D016138:Walking