Presentation: Outcomes from the Arthritis Foundation Exercise Program: A Randomized Controlled Trial (2007)

724 Outcomes from the Arthritis Foundation Exercise Program: A Randomized Controlled Trial

PURPOSE: The purpose of this study was to determine outcomes of the Arthritis Foundation Exercise Program (PACE). METHODS: A randomized controlled trial of 174 community-dwelling adults who reported a rheumatic disease was conducted to compare PACE to no PACE and 8 weeks to 16 weeks of PACE. Eligible volunteers were randomized to either the delayed training group that participated in 8 weeks of classes after an initial 8 week delay (DTG, n=85) or the 16 week training group (TG, n=89)). Classes met three times a week. Standardized outcome measures were selected to reflect stated PACE goals and content and included self-reported and measured physical function, pain, fatigue, self-esteem and self-efficacy for arthritis symptom management. Data were collected at baseline, eight and 16 weeks and at six month follow-up by staff blinded to group assignment. PACE leaders were trained by one instructor according to the training manual and class content monitored to assure consistency and compliance. Analyses of covariance were used to determine between group differences. Effect sizes (ES) were calculated for two-group comparisons. Intention to treat analysis was performed using a mixed model. RESULTS: Groups were similar at baseline on all measures. The sample was 90% white females who had seen a physician in the last 12 months. Mean age was 65.2 years. Reported diagnoses included OA, RA, fibromylagia, SLE, psoriatic arthritis and polymyalgia rheumatica. Eight weeks of PACE compared to no PACE resulted in statistically significant improvements in self-reported function (p.001, ES .49); measured function (p.007, ES.39); pain (p.04, ES .26); fatigue (p.017, ES.34); and arthritis self-management efficacy (p.007, ES .46). Sixteen weeks of PACE compared to eight weeks resulted in significant between group differences in physical function both self-reported (p.019, ES .51)and measured (p.013, ES.49), and arthritis self-management efficacy (p.024, ES .48). There were no differences in self-esteem. There were no differences between TG and DTG at six month follow-up. Retention at 16 weeks and six months was 86% and 82%, respectively. Non-completers compared to completers reported more fatigue, lower self-esteem and lower physical function at baseline. Mixed model analysis showed that attendance was positively related to improvements in arthritis self-management efficacy (p.0005), pain (p.0299) and self-reported function (p.0058). CONCLUSIONS: Participation in PACE three days a week for eight weeks resulted in statistically significant and clinically meaningful improvements in pain, fatigue, function and self-efficacy for managing symptoms. This finding provides evidence that PACE goals can be met in an eight week, three days a week offering. Sixteen weeks of PACE resulted in minimal differences compared to eight weeks.

 M.A. Minor, None; E. Prost, None; M. Nigh, None; B. Ge, None; J.E. Hewett, None.

<< Previous Presentation | Next Presentation