Fit and Strong!: Promoting maintenance to exercise among older adults with lower-extremity osteoarthritis

Osteoarthritis (OA) is the most common condition affecting older adults today, and the leading cause of disability among older people. Many people with OA become sedentary as a result of painful lower extremity joints. Currently, little is known about effective methods to promote maintenance of physical activity in this high risk group. Fit and Strong! is an evidence-based, low-cost, multiple component program that targets older adults with lower extremity OA. The program meets for eight weeks and combines flexibility, fitness walking/ low-impact aerobics, and strength training with health education and group problem-solving for sustained behavior change. A randomized controlled trial was conducted to test the impact of negotiated vs. mainstreamed follow up with and without telephone reinforcement on maintenance of physical activity after Fit and Strong! ends. Single group random effects analyses of two, six, 12 and 18 month outcomes showed significant improvements on exercise maintenance that were accompanied by decreased lower extremity (LE) pain and stiffness, improved LE function, sit stand, and 6 minute distance walk and decreased anxiety. Analyses by follow-up condition showed benefits associated with negotiated follow up, telephone reinforcement combined with negotiated follow-up and number of reinforcement calls received. Findings indicate that the negotiated follow-up contract that Fit and Strong! uses is associated with positive long-term participant outcomes that can be enhanced by telephone reinforcement.