New NIH fit and strong! plus physical activity/weight loss trial

Background: Osteoarthritis (OA) is the primary cause of disability among older adults in the U.S. Persons with lower extremity (LE) OA who are overweight are at particular risk (Felson, 1992). In 2007, obesity prevalence was 54% higher among adults with arthritis who were 44% more likely to be physically inactive (Hootman et al., 2011b). The 8-week Fit and Strong! exercise program increases physical activity (PA) and improves LE strength and mobility out to 18 months (Hughes et al., 2010). The new Fit and Strong! Plus program has been designed to address both PA and weight management but has not been tested. Methods: This comparative effectiveness trial is randomly assigning 400 participants to customary Fit and Strong! or Fit and Strong! Plus and comparing outcomes at 2, 6, 12, 18, and 24 months. Both 8-week interventions are followed by tapered telephone reinforcement. We hypothesize that Fit and Strong! Plus participants will show significantly improved diet behaviors at 2 months along with weight loss (≥ 5%) at 6 months that will be maintained at 24 months. Fit and Strong! Plus participants will also differentially improve in PA maintenance and LE pain, stiffness, function, balance, mobility, depression and anxiety at all time points.

Results: Earlier single group (N =11) pre-post pilot data on Fit and Strong! Plus showed decreased weight (1.63 lbs), BMI (0.72) and fat consumption (P =.064) at 4 weeks. The current trial design, intervention components, recruitment, and 2 month outcomes to date will be described.