Evaluation of Arthritis Foundation Exercise Program
Studies have shown that people with arthritis can safely participate in exercise programs to improve their cardiovascular fitness, muscular strength, psychological outlook and physical function. The People with Arthritis Can Exercise (PACE) program – now called the Arthritis Foundation Exercise Program – is a land-based course that promotes self-management of arthritis through exercise.
What Problem Was Studied?
For successful widespread dissemination of the Program, solid evidence-based data to show its efficacy is needed. To attain such evidence-based data, a randomized controlled trial was conducted that measured short-term and long-term effects of the Program on symptoms, function, physical activity and a set of psychosocial measures. This study was not funded by the Arthritis Foundation, but by the Centers for Disease Control and Prevention through a grant from the Association of American Medical Colleges.
|The Arthritis Foundation Exercise Program is available through local Arthritis Foundation chapters, or you can purchase a DVD to do the exercises in your own home.|
A total of 346 people with arthritis participated in the study; none were frequent exercisers, and all had some limitation in their normal activities because of arthritis. The participants were separated into an intervention group and a control group.
For this study, participants carried out most of the movements standing or from a chair. No floor exercises were performed. In practice, the Arthritis Foundation Exercise Program classes are given at an intensity level appropriate to the people taking the class. The exercise program consisted of twice-weekly, one-hour sessions for eight weeks.
All participants completed assessments at baseline and at the end of the Program. After the eight-week assessment, the control group received the intervention. Pain, stiffness and fatigue were measured using visual scales. Physical function was assessed with self-report and performance measures. Physical activity was scored according to type of activity, frequency and duration. Self-efficacy, depression and helplessness were assessed using various questionnaires.
What Were the Study Results?
Those participants who attended at least nine of the 16 classes showed improvement in pain, fatigue and stiffness, in some arm and leg strength and in self-confidence that they could manage their arthritis. Six months after completing the Program, pain and fatigue were still better than at baseline, but disability and self-efficacy measures were not. However, the subset of participants that continued exercising at home maintained improvement in all symptoms and declined only in self-efficacy for physical activity – which is defined as the knowledge that you have the ability and self-motivation to exercise.
What Does this Mean for People with Arthritis?
The authors conclude that the Arthritis Foundation Exercise Program (formerly known as PACE) “modestly improves symptoms and strength but does not improve function, increase exercise endurance, or increase physical activity.” They go on to suggest, “For more substantial benefits, frequency and intensity may need to be increased.”
Callahan LF, Mielenz T, Freburger J, et al. A randomized controlled trial of the People with Arthritis Can Exercise Program: symptoms, function, physical activity, and psychosocial outcomes. Arthritis Care Res 2008;59:92-101.
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