Non-Pharmacologic Management
Abstract# 2080 - A Randomized Controlled Trial (RCT) of Active Living Every Day (ALED) in Individuals with Arthritis
Authors: L. F. Callahan et al.
Background: Physical activity is important to promote general health and appears to benefit symptoms in people with arthritis. In this study, Callahan et al evaluated the benefits of a physical activity program (Active Living Every Day: ALED) on important arthritis-related outcomes.
Methods: Three hundred and fifty–four sedentary adults with self-reported arthritis aged ≥18 years completed a series of questionnaires and physical function tests and were then randomized to either the ALED condition or a control condition. The ALED group participated in a 20 week intervention designed to provide them with the behavioral skills to become and stay physically active, while the control condition simply completed the study measures. Participants were evaluated at baseline and after the ALED intervention. They also completed self-report surveys at 6- and 12-months post-intervention. Study measures included: the HAQ disability index, pain, stiffness, and fatigue visual analog scales, the Arthritis Self-Efficacy Scale, a measure of physical activity, physical function tests, and the like. Analyses were performed as both intention-to-treat (ITT) and actual treatment (AT) (only the ITT results are presented).
Results: The average age of participants was 69 years; 22% were Black, 84% were women and over half (58%) completed at least high school. At baseline, participants were comparable on all study measures. At 20 weeks, however, the participants in the ALED condition significant improvement (p <0.05) on all outcomes related to physical function including gait speed, chair stands, 2-minute step, and physical activity. Compared to baseline, 12 months after the completion of the intervention the ALED group maintained increased physical activity and decreased their stiffness. No adverse reports were reported during the trial.
Conclusions: The ALED intervention appears to provide a safe and effective way for persons with arthritis to increase their physical activity. The ALED–induced physical activity produced improvements on several arthritis outcomes.
Editorial Comments: The 20-week ALED protocol, which emphasizes the gradual increase in physical activity (primarily brisk walking) coupled with cognitive-behavioral strategies to address issues related to goal setting and relapse prevention, produced a significant increase in physical activity among adults with self-reported arthritis. Moreover, the increased physical activity produced significant improvements in physical functioning and on a variety of arthritis-related symptoms. Follow-up one year after ALED indicated that a number of the benefits were maintained, most notably the increase in physical activity. The ALED intervention appears to have advantages over traditional exercise in that it does not require special equipment or membership to a health club. Moreover, because the increased physical activity is derived from self-selected activities, it may be easier to sustain over time. The benefits of a physically activity lifestyle are considerable and this study suggests that older adults with arthritis can significantly increase their physical activity in relatively short order.
