Home Page - About the Arthritis Center -Hopkins Rheumatology - Myositis Center - Vasculitis Center - Scleroderma Center
| |
 
|
|
| Kevin Fontaine, Ph.D.
| ||
|
Abstract 1110 Are U.S. Adults Meeting Physical Activity Recommendations? Using population-based phone survey data from the 2001 Behavioral Risk Factor Surveillance Survey (BRFSS), this study estimates the prevalence of US adults reporting doctor-diagnosed arthritis who meet the Surgeon Generals physical activity (PA) recommendations. Overall, 24.8% were physically inactive compared with 13.7% of adults without arthritis. Thirty eight percent of adults with arthritis reported meeting PA recommendations compared with 47.4% of those without arthritis. The highest prevalence of inactivity was found among those with fewer than 11 years of education, Blacks, those aged 65 years and older, and Hispanics. Editorial Comment: These data suggest that only about 4 in 10 adults with arthritis are meeting public health physical activity recommendations. Nonetheless, this represents an increase in prevalence from previous surveys. Although it is likely that the increased prevalence observed in this study is due in large part to the improved assessment of moderate-intensity physical activity in the BRFSS, the findings are still encouraging. Given the benefits of physical activity for adults with arthritis, rheumatologists and allied health professionals should routinely prescribe and monitor the physical activity of their patients. | ||
|
Abstract 1803 Effects of a Sun-style Tai Chi Exercise on Motivation and the Performance of Health Behaviors in Older Women with Osteoarthritis Seventy women with knee osteoarthritis (OA) were assigned randomly to either 12 weeks of Tai Chi exercise, consisting of 12 slow circular movements to less impact on their knee joints while inducing muscle strengthening and symptom alleviation, or controls who received standard care. Outcome measures were pain and stiffness, motivation to practice health behaviors, and an assessment of health behaviors. At the end of the intervention, the Tai Chi group reported significantly less pain and stiffness, higher intention to exercise, higher perceived benefits, better dietary practices, and enhanced stress management. Editorial Comment: Tai Chi appears to be a safe and beneficial form of physical activity form women with knee OA. Interestingly, in this study, the benefits of Tai Chi go beyond OA symptom management in that participants in the Tai Chi group also reported a higher intention to exercise, better dietary control, and enhanced stress management. Thus, initiating Tai Chi appears to associate with the onset of a cascade of health behaviors that, if sustained, would likely promote both improved OA management and general health. The mechanism by which Tai Chi promotes a healthy lifestyle remains to be determined. | ||
|
Abstract 1759 Demographic Determinants of Physical Inactivity Among People with Arthritis or Chronic Joint Symptoms Logistic regressions were used to identify demographic correlates of physical inactivity among people with doctor-diagnosed arthritis or chronic joint symptoms using data from the 2001 Behavioral Risk Factor Surveillance Survey. The demographic groups with the greatest likelihood of physical inactivity included: those over age 65, Blacks, females, those with less than a high school education, persons unable to work, widowers, those with income <$25,000/year, obese, and those belonging to a health plan. Editorial Comment: This study suggests that certain subgroups are at increased risk of being physically inactive. This information is essential since the goal of public health interventions is to promote behavior change in the widest variety of individuals possible. Thus, identifying subgroups that are not responding to public health messages is vital to refine and improve the uptake of the campaign. By identifying those subgroups most likely to be physically inactive this study may inform the development of targeted interventions designed to promote increased physical activity in these high risk subgroups. | ||
|
Abstract 1675 Predictors of Dropout among Participants in an Osteoarthritis Exercise Study This study assesses the predictive ability of study baseline characteristics (e.g. disease burden) on eventual dropout from exercise trials for persons with osteoarthritis. Data collected included demographics, radiological information, range of motion, and functional assessment. Of 142 participants, 52% were retained and 48% dropped out. Early dropout (within 6 months) was associated with both frequency of arthritis medication usage and self-reported doctors visits the year prior to enrollment, while late dropout (between 6 and 24 months) was associated with baseline foot osteoarthritis and arthritis medication usage. Frequency of arthritis medication usage the month prior to enrollment was predictive of early and late dropout. Age, marital status, gender, income, and education were not predictors of dropout. Editorial Comment: Although exercise and physical activity programs have been shown to benefit persons with OA, dropouts are a major drawback. Thus, investigators search for both determinants and correlates of dropping out of exercise programs. This study suggests that some baseline factors may be useful in identifying those at increased risk of abandoning an exercise program. Interestingly, this study does not suggest, as have other studies, that demographic factors such as age and education predict drop outs. Rather, this study suggests that disease-specific factors (number of doctor visits, medication usage) are most salient in predicting drop outs. Obviously, given that these findings run counter to previous research, they need to be replicated. If they hold true, however, it would imply that characteristics of the disease process itself may play a vital role in determining whether exercise is maintained. | ||
|
Abstract 1109 Health Care Provider Support for Physical Activity in Older Women with Rheumatoid Arthritis To examine the frequency of health care provider (HCP) support for vigorous-intensity physical activity among older women with rheumatoid arthritis (RA), 101 participants were asked to respond to the self-administered questionnaire that included measures of demographics and HCP support for physical activity. Only 27% reported their health care providers as being supportive of vigorous activity, while 45% felt discouraged by their providers to be active, and 29% were undecided. Editorial Comment: Nearly two-thirds of the older women with RA sampled felt either discouraged or undecided about whether their HCPs encouraged them to engage in vigorous physical activity. This is discouraging since a physically active lifestyle may assist persons with RA to better manage both their disease and their general health. An obvious problem with this study is that it is unclear whether HCPs also did not encourage moderate-intensity physical activity. It may well be that HCPs are not promoting vigorous-intensity physical activity for fear that high intensity activity may exacerbate disease activity and thereby compromise self-management. However, since it is well-documented that moderate-intensity physical activity can be beneficial, HCPs should devote some time to educating and encouraging their RA patients to develop a more physically active lifestyle. | ||
|
Abstract 1054 The Efficacy of Two Arthritis Management Programs: Walk With Ease & You Can Break the Pain Cycle The effectiveness of two Arthritis Foundation programs, a supervised walking program (Walk with Ease) and a self-management program (You Can Break The Pain Cycle) was evaluated. One hundred two individuals with arthritis participated in the self-management program (Group A), 29 in the walking program (Group B), and 33 in both programs (Group C). The six-week walking program met three times weekly for one hour and the self-management program met once; both programs were conducted by trained leaders. Before participation, participants completed a self-report survey and three physical assessments (the Six Minute Walk Test, Standing Squat Test and Timed Functional Walking Test). Measures were repeated 6 weeks and 4 months after each program started. All groups showed significant gains in the 6-minute walk and the squat tests, as well as changes in perceptions on physical capabilities, negative emotions, and feelings about arthritis at all subsequent assessments. Editorial Comment: Both interventions produced improvements on psychosocial domains and on physical performance. Given the ever increasing prevalence of OA, short, easily accessible interventions that require minimal resources are essential to assist persons with arthritis to better manage their disease. The two interventions hold great promise and are likely to promote greater emphasis on physical activity as a necessary component to self-manage arthritis. Easing arthritis patients into physical activity via these educational interventions may prove vital in efforts to promote and sustain increased levels of physical activity over a life time. | ||
|
Abstract 1053 Effects of a Heat-Retaining Sleeve on Pain, Stiffness, and Function in Knee Osteoarthritis (OA) To examine the effects of heat-retaining knee sleeve on pain, stiffness, and function in patients with knee OA, 52 adults with knee OA were randomized to wear either an experimental or placebo sleeve for =12 hours/day for 4 weeks. The sleeves were identical except that the experimental sleeve contained a polyester substrate liner to retain heat. In participants with bilateral OA, the sleeve was worn on the most painful knee. All subjects continued their usual medication regimen. Outcomes were evaluated at baseline, 2 and 4 weeks during sleeve use, and 2 and 4 weeks after cessation. After 4 weeks wearers of the experimental sleeve reported a 16% decrease, relative to baseline, in pain (P <.001). The placebo sleeve produced a 9.7% decrease from baseline (P <.002). However, the between treatment groups differences on pain were not statistically significant (P = 0.12), and pain returned to baseline levels of within 4 weeks after cessation of sleeve use. Editorial Comment: Although only a pilot study, these findings are promising: the heat-retaining sleeve may provide a simple, cost effective therapy for persons with knee OA to better manage their pain. If it is definitively demonstrated in a large-scale trial that the heat retaining sleeve is better than placebo at reducing pain, heat retention may become a sole treatment, perhaps for mild OA, or used in conjunction with pharmacotherapy. Ideally, the heat retaining sleeve would attenuate the use of medications and reduce medical costs and possible drug toxicity. | ||
|
Abstract 710 "Deep Water Running" to Treat Fibromyalgia an Aerobic Training in a Swimming Pool: a Randomized, Controlled Study This study compares the effects of water aerobic exercise and land-based aerobic exercise in women with fibromyalgia (FM). Sixty sedentary women with FM were randomized to either 15 weeks of deep water running (DWR) in a warmed swimming pool, or land-based exercise (LBE) involving walking or jogging. Outcomes included aerobic fitness, health-related quality of life, the fibromyalgia impact questionnaire (FIQ), and self-reported global improvement, measured at baseline, week 8, and week 15. Patients were asked to maintain their drug regimens, and analgesics were allowed as a rescue medication. Both groups improved significantly after 15 weeks when compared to baseline values on self-reported global improvement, and domains of the FIQ. At week 15, DWR was better than LBE on FIQ total score (p=0.017) and FIQ depression (p=0.028). No significant between-group differences were found on the other outcomes. Editorial Comment: According to this study, deep water running exercise provides an efficacious alternative to land based exercise for adults with FM. Although both interventions produced marked improvements relative to baseline, the deep water exercise intervention reduced depression to a greater extent than did land based exercise. The reason for this is unclear but, if valid, may relate to the soothing properties associated with exercising in warm water. The potential advantage of deep water exercise may be offset somewhat by the fact that access to a pool may be problematic for some. Nonetheless, deep water exercise may provide a powerful and appealing alternative to traditional exercise for persons with FM, especially those who are fearful that the jarring that comes with land-based exercise might worsen their disease. | ||
| ((top of page)) (next page)
|
||
