A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis

The Fitness Arthritis and Seniors Trial (FAST)

Walter H. Ettinger, Robert Burns, Stephen P. Messier, William Applegate, W. Jack Rejeski, Timothy Morgan, Sally Shumaker, Michael J. Berry, Mary O'Toole, Johnny Monu, Timothy Craven

Research output: Contribution to journalArticle

1036 Citations (Scopus)

Abstract

Objective.-To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. Setting and Design.-A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. Participants.-A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. Interventions.-An aerobic exercise program, a resistance exercise program, and a health education program. Main Outcome Measures.-The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x- ray score, aerobic capacity, and knee muscle strength. Results.-A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (±SE) score on the physical disability questionnaire (1.71 ± 0.03 vs 1.90 ± 0.04 units; P<.001), a 12% lower score on the knee pain questionnaire (2.1 ± 0.05 vs 2.4 ± 0.05 units; P=.001), and performed better (mean [± SE]) on the 6-minute walk test (1507 ± 16 vs 1349 ± 16 ft; P<.001), mean (±SE) time to climb and descend stairs (12.7±0.4 vs 13.90± 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 ± 0.2 vs 10.0 ± 0.1 seconds; P<.001), and mean (±SE) time to get in and out of a car (8.7± 0.3 vs 10.6 ± 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74 ± 0.04 vs 1.90 ± 0.03 units; P=.003), 8% lower pain score (2.2 ± 0.06 vs 2. 4 ± 0.05 units; P=.02), greater distance on the 6-min ute walk (1406 ± 17 vs 1349 ± 16 ft; P= .02), faster times on the lifting and carrying task (9.3 ± 0.1 vs 10.0±0.16 seconds; P=.001), and the car task (9.0 ± 0.3 vs 10.6 ± 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. Conclusions.-Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalJournal of the American Medical Association
Volume277
Issue number1
StatePublished - Jan 1 1997

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Knee Osteoarthritis
Health Education
Arthritis
Exercise
Pain
Knee
X-Rays
Independent Living
Resistance Training
Muscle Strength
Disabled Persons
Prescriptions
Outcome Assessment (Health Care)
Clinical Trials
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis : The Fitness Arthritis and Seniors Trial (FAST). / Ettinger, Walter H.; Burns, Robert; Messier, Stephen P.; Applegate, William; Rejeski, W. Jack; Morgan, Timothy; Shumaker, Sally; Berry, Michael J.; O'Toole, Mary; Monu, Johnny; Craven, Timothy.

In: Journal of the American Medical Association, Vol. 277, No. 1, 01.01.1997, p. 25-31.

Research output: Contribution to journalArticle

Ettinger, Walter H. ; Burns, Robert ; Messier, Stephen P. ; Applegate, William ; Rejeski, W. Jack ; Morgan, Timothy ; Shumaker, Sally ; Berry, Michael J. ; O'Toole, Mary ; Monu, Johnny ; Craven, Timothy. / A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis : The Fitness Arthritis and Seniors Trial (FAST). In: Journal of the American Medical Association. 1997 ; Vol. 277, No. 1. pp. 25-31.
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abstract = "Objective.-To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. Setting and Design.-A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. Participants.-A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. Interventions.-An aerobic exercise program, a resistance exercise program, and a health education program. Main Outcome Measures.-The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x- ray score, aerobic capacity, and knee muscle strength. Results.-A total of 365 (83{\%}) participants completed the trial. Overall compliance with the exercise prescription was 68{\%} in the aerobic training group and 70{\%} in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10{\%} lower adjusted mean (±SE) score on the physical disability questionnaire (1.71 ± 0.03 vs 1.90 ± 0.04 units; P<.001), a 12{\%} lower score on the knee pain questionnaire (2.1 ± 0.05 vs 2.4 ± 0.05 units; P=.001), and performed better (mean [± SE]) on the 6-minute walk test (1507 ± 16 vs 1349 ± 16 ft; P<.001), mean (±SE) time to climb and descend stairs (12.7±0.4 vs 13.90± 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 ± 0.2 vs 10.0 ± 0.1 seconds; P<.001), and mean (±SE) time to get in and out of a car (8.7± 0.3 vs 10.6 ± 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8{\%} lower score on the physical disability questionnaire (1.74 ± 0.04 vs 1.90 ± 0.03 units; P=.003), 8{\%} lower pain score (2.2 ± 0.06 vs 2. 4 ± 0.05 units; P=.02), greater distance on the 6-min ute walk (1406 ± 17 vs 1349 ± 16 ft; P= .02), faster times on the lifting and carrying task (9.3 ± 0.1 vs 10.0±0.16 seconds; P=.001), and the car task (9.0 ± 0.3 vs 10.6 ± 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. Conclusions.-Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.",
author = "Ettinger, {Walter H.} and Robert Burns and Messier, {Stephen P.} and William Applegate and Rejeski, {W. Jack} and Timothy Morgan and Sally Shumaker and Berry, {Michael J.} and Mary O'Toole and Johnny Monu and Timothy Craven",
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T1 - A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis

T2 - The Fitness Arthritis and Seniors Trial (FAST)

AU - Ettinger, Walter H.

AU - Burns, Robert

AU - Messier, Stephen P.

AU - Applegate, William

AU - Rejeski, W. Jack

AU - Morgan, Timothy

AU - Shumaker, Sally

AU - Berry, Michael J.

AU - O'Toole, Mary

AU - Monu, Johnny

AU - Craven, Timothy

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Objective.-To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. Setting and Design.-A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. Participants.-A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. Interventions.-An aerobic exercise program, a resistance exercise program, and a health education program. Main Outcome Measures.-The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x- ray score, aerobic capacity, and knee muscle strength. Results.-A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (±SE) score on the physical disability questionnaire (1.71 ± 0.03 vs 1.90 ± 0.04 units; P<.001), a 12% lower score on the knee pain questionnaire (2.1 ± 0.05 vs 2.4 ± 0.05 units; P=.001), and performed better (mean [± SE]) on the 6-minute walk test (1507 ± 16 vs 1349 ± 16 ft; P<.001), mean (±SE) time to climb and descend stairs (12.7±0.4 vs 13.90± 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 ± 0.2 vs 10.0 ± 0.1 seconds; P<.001), and mean (±SE) time to get in and out of a car (8.7± 0.3 vs 10.6 ± 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74 ± 0.04 vs 1.90 ± 0.03 units; P=.003), 8% lower pain score (2.2 ± 0.06 vs 2. 4 ± 0.05 units; P=.02), greater distance on the 6-min ute walk (1406 ± 17 vs 1349 ± 16 ft; P= .02), faster times on the lifting and carrying task (9.3 ± 0.1 vs 10.0±0.16 seconds; P=.001), and the car task (9.0 ± 0.3 vs 10.6 ± 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. Conclusions.-Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.

AB - Objective.-To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. Setting and Design.-A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. Participants.-A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. Interventions.-An aerobic exercise program, a resistance exercise program, and a health education program. Main Outcome Measures.-The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x- ray score, aerobic capacity, and knee muscle strength. Results.-A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (±SE) score on the physical disability questionnaire (1.71 ± 0.03 vs 1.90 ± 0.04 units; P<.001), a 12% lower score on the knee pain questionnaire (2.1 ± 0.05 vs 2.4 ± 0.05 units; P=.001), and performed better (mean [± SE]) on the 6-minute walk test (1507 ± 16 vs 1349 ± 16 ft; P<.001), mean (±SE) time to climb and descend stairs (12.7±0.4 vs 13.90± 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 ± 0.2 vs 10.0 ± 0.1 seconds; P<.001), and mean (±SE) time to get in and out of a car (8.7± 0.3 vs 10.6 ± 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74 ± 0.04 vs 1.90 ± 0.03 units; P=.003), 8% lower pain score (2.2 ± 0.06 vs 2. 4 ± 0.05 units; P=.02), greater distance on the 6-min ute walk (1406 ± 17 vs 1349 ± 16 ft; P= .02), faster times on the lifting and carrying task (9.3 ± 0.1 vs 10.0±0.16 seconds; P=.001), and the car task (9.0 ± 0.3 vs 10.6 ± 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. Conclusions.-Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.

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