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Rory Suomi and Susan Lindauer

The purpose of this study was to ascertain the effect of Arthritis Foundation Aquatic Program (AFAP) exercises on strength and range of motion (ROM) measures in women with arthritis. Exercise group (EX) subjects (n = 17) trained three times a week for 6 weeks in AFAP classes. Pre- and posttest isometric strength and ROM tests were conducted on shoulder and hip abduction movements on both limbs. For hip abduction. EX subjects made significant increases in isometric strength and ROM measures ranging from 13.0 to 17.0%. No significant changes in strength or ROM measures for shoulder abduction were found for the EX group. The control group (n = 10) demonstrated no significant changes in isometric or ROM measures for either joint test. The basic 6-week AFAP protocol appears sufficient to induce strength and ROM changes in joints affected by arthritis but may not be sufficient to induce similar changes for joint motions not affected by arthritis.

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Cheryl Der Ananian, Renae Smith-Ray, Brad Meacham, Amy Shah and Susan Hughes

Primarily due to the aging of the U.S. population, the public health burden of arthritis is expected to increase substantially. The proportion of adults with arthritis is projected to increase to nearly 1 in 4 adults by 2030. While it is anticipated adults over the age of 65 will account for 50% of

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Leigh F. Callahan, Rebecca J. Cleveland, Mary Altpeter and Betsy Hackney

Objective:

Evaluate effectiveness of the Arthritis Foundation Tai Chi Program for community participants with arthritis.

Methods:

343 individuals were randomized to either the intervention or wait-list control group. Performance and self-reported outcome (SRO) measures were assessed at baseline and eight weeks. At one year, SROs only were assessed. Adjusted means were determined using regression models adjusting for covariates, and effect sizes (ES) were calculated.

Results:

Average participant age was 66 years, 87% were female, and 87% were Caucasian. Among 284 (83%) participants who returned at eight weeks, balance by reach (ES = 0.30) and helplessness, sleep, and role participation satisfaction (ES = 0.24–0.54) improved significantly; pain, fatigue, and stiffness improvement (ES = 0.15–0.23) approached significance. No change was noted in mobility, lower extremity strength, or single-leg stance balance. At one year, improvements in pain, fatigue, stiffness, helplessness, and role participation satisfaction at eight weeks were maintained; 30% continued tai chi practice.

Conclusion:

Moderate effectiveness of the Arthritis Foundation Tai Chi Program was confirmed.

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Scott W. Cheatham, Kyle R. Stull, Mike Fantigrassi and Ian Montel

included in this analysis. The search terms used included individual or a combination of the following: hip, joint, arthritis, pain, range of motion (ROM), fatigue, tightness, pathology, condition, muscle, intraarticular, extraarticular, femoroacetabular impingement, single leg, bilateral, squat

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Cheryl Der Ananian, Sara Wilcox, Ken Watkins, Ruth P. Saunders and Alexandra E. Evans

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis. Using a cross-sectional design, sociodemographic, health-related, and psychosocial variables were collected from community-dwelling individuals with arthritis (N = 141). Associations with exercise level were examined with bivariate statistics (ANOVAs, chi-squares) and logistic-regression analyses. Exercisers were less likely than nonexercisers and insufficiently active people to report that arthritis negatively affected their physical and social functioning, and they reported more positive affect and greater self-efficacy (p < .05). Exercisers also reported less pain than nonexercisers (p < .05). In multiple logistic-regression analyses, self-efficacy and physical limitations remained independent predictors of exercise. The results suggest the need to target exercise self-efficacy when designing exercise interventions. Results also suggest the need to tailor exercise programs to individuals’ physical limitations.

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Geeske Peeters, Wendy Brown and Nicola Burton

Background:

Patient-group specific preferences can be used to design physical activity programs. This study compared physical activity context preferences between (1) people with musculoskeletal conditions (ie, arthritis and/or osteoporosis) and people without these conditions, and (2) people with arthritis only and people with osteoporosis only.

Methods:

Data were from 1684 participants (57.2 ± 6.6 years) with self-reported arthritis and/or osteoporosis and 4550 participants (52.9 ± 6.9 years) without these conditions. Participants indicated the extent to which they disagreed/agreed with a preference for each of 14 contexts. Marginal means and 95% confidence intervals are presented, differences were tested with ANCOVA.

Results:

Compared with participants without musculoskeletal conditions, those with arthritis and/or osteoporosis indicated a slightly stronger preference for activities that are not just about exercise [3.55 (3.51–3.59) vs. 3.49 (3.46–3.52), P = .02], and a weaker preference for vigorous activities [3.02 (2.97–3.06) vs. 3.08 (3.06–3.11), P = .02], and activities with a set routine or format [3.29 (3.24–3.33) vs. 3.35 (3.32–3.38), P = .02]. Participants with arthritis only [n = 1063, 2.64, (2.59–2.70)] had a stronger preference against supervision than those with osteoporosis only [n = 146, 2.84 (2.69–2.99); P = .02].

Conclusions:

Only small differences were found in the activity context preferences between people with and without musculoskeletal conditions, and between people with osteoporosis and people with arthritis. The context of physical activity interventions for people with arthritis and/or osteoporosis does not have to be different from those for people without these conditions.

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Yvonne M. Golightly, Stephen W. Marshall, Leigh F. Callahan and Kevin Guskiewicz

Background:

Injury has been identified as a potential risk factor for osteoarthritis. However, no previous study has addressed playing-career injuries and subsequent osteoarthritis in a large sample of former athletes. The purpose of this study was to describe the prevalence and determinants of arthritis and osteoarthritis in retired professional football players.

Methods:

Self-reported arthritis prevalence and retrospectively-recalled injury history were examined in a cross-sectional survey of 2,538 retired football players.

Results:

Football players reported a high incidence of injury from their professional playing days (52.8% reported knee injuries, 74.1% reported ligament/tendon injuries, and 14.2% reported anterior cruciate ligament tears). For those under 60 years, 40.6% of retired NFL players reported arthritis, compared with 11.7% of U.S. males (prevalence ratio =3.5, 95%CI: 3.3 to 3.7). Within the retired NFL player cohort, osteoarthritis was more prevalent in those with a history of knee injury (prevalence ratio = 1.7, 95%CI: 1.5 to 1.9) and ligament/tendon injury (prevalence ratio = 1.6, 95%CI: 1.4 to 1.9).

Conclusions:

In males under the age of 60, arthritis is over 3 times more prevalent in retired NFL players than in the general U.S. population. This excess of early-onset arthritis may be due to the high incidence of injury in football.

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Joe Feinglass, Jungwha Lee, Pamela Semanik, Jing Song, Dorothy Dunlop and Rowland Chang

Background:

This study analyzes Chicago-area weather effects on objectively measured physical activity over a 3-year period among a cohort of 241 participants in an on-going arthritis physical activity trial.

Methods:

Uniaxial accelerometer counts and interview data were analyzed for up to 6 weekly study waves involving 4823 days of wear. The effects of temperature, rainfall, snowfall and daylight hours were analyzed after controlling for participant characteristics, day of the week, and daily accelerometer wear hours in a mixed effects linear regression model.

Results:

Daylight hours, mean daily temperature < 20 or ≥ 75 degrees, and light or heavy rainfall (but not snowfall) were all significantly associated with lower physical activity after controlling for the significant effects of weekends, accelerometer wear hours, age, sex, type of arthritis, employment, Hispanic ethnicity, obesity, and SF36 physical and mental health scores.

Conclusions:

The cumulative effects of weather are reflected in a 38.3% mean monthly difference in daily counts between November and June, reflecting over 3 additional hours of sedentary time. Physical activity promotion programs for older persons with chronic conditions need lifestyle physical activity plans adapted to weather extremes.

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Leigh F. Callahan, Rebecca J. Cleveland, Jack Shreffler, Jennifer M. Hootman, Thelma J. Mielenz, Britta Schoster, Teresa Brady and Todd Schwartz

Background:

Adults with arthritis can benefit from participation in physical activity and may be assisted by organized programs. The purpose of this study was to evaluate the effectiveness of a 20-week behavioral lifestyle intervention, Active Living Every Day (ALED), for improvements in primary outcomes (physical activity levels, aerobic endurance, function, symptoms).

Methods:

A 20-week randomized controlled community trial was conducted in 354 adults. Outcomes were assessed at baseline and 20 weeks in the intervention and wait-list control groups. The intervention group was also assessed at 6 and 12 months. Mean outcomes were determined by multilevel regression models in the intervention and control groups at follow-up points.

Results:

At 20 weeks, the intervention group significantly increased participation in physical activity, and improved aerobic endurance, and select measures of function while pain, fatigue and stiffness remained status quo. In the intervention group, significant improvements in physical activity at 20 weeks were maintained at 6 and 12 months, and stiffness decreased.

Conclusions:

ALED appears to improve participation in physical activity, aerobic endurance, and function without exacerbating disease symptoms in adults with arthritis.

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Marie Tierney, Alexander Fraser and Norelee Kennedy

Background:

Physical activity is associated with improved health outcomes in many populations. It is assumed that physical activity levels in the rheumatoid arthritis (RA) population may be reduced as a result of symptoms of the disease. The objective of this review is to establish the current evidence base for levels of physical activity in the RA population.

Methods:

A systematic review was performed of 7 databases (Ema-base, MEDLINE, AMED, Biomedical Reference Collection Expanded, CINAHL, Nursing and Allied Health Collection, and SportsDiscus) up to February 2011 to examine the evidence in the area.

Results:

One hundred and thirty-six studies were identified through electronic searching. One hundred and six were excluded based on title and/or abstract analysis and a further 14 were excluded based on full text analysis. Sixteen studies meeting the criteria were deemed suitable for inclusion. The results of the included studies indicate that the level of physical activity may be lower among individuals with RA when compared with healthy controls or normative data.

Conclusions:

There are a number of methodological considerations at play within the studies reviewed which prohibits definitive conclusion on the physical activity levels of this population group. Given the known health benefits of physical activity, further research in this area appears indicated.