title: Long-term impact of Fit and Strong! on older adults with osteoarthritis.
abstract: OBJECTIVE
  We present final outcomes from the multiple-component Fit and Strong! intervention for older adults with lower extremity osteoarthritis.
  
  
  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.
  
  
  CONCLUSIONS
  This consistent pattern of benefits indicates that this low-cost intervention is efficacious for older adults with lower extremity osteoarthritis.
authors.affiliation: Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, Room 558, Chicago, IL 60608, USA. shughes@uic.edu.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hughes
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Seymour
authors.forename: Richard T
authors.initials: RT
authors.lastname: Campbell
authors.forename: Gail
authors.initials: G
authors.lastname: Huber
authors.forename: Naomi
authors.initials: N
authors.lastname: Pollak
authors.forename: Leena
authors.initials: L
authors.lastname: Sharma
authors.forename: Pankaja
authors.initials: P
authors.lastname: Desai
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology / Q000534:rehabilitation*; D010349:Patient Compliance; D016059:Range of Motion, Articular / Q000502:physiology; D020377:Self Efficacy; D016896:Treatment Outcome