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Arnold School of Public Health


Study determines efficacy of self-directed programs for adults with arthritis, significant improvements in multiple areas for both types of interventions

January 14, 2015 | Erin Bluvas, bluvase@sc.edu 

A team of researchers led by Sara Wilcox, professor of exercise science at the Arnold School of Public Health, found that two different self-directed programs improved outcomes for adults with arthritis.

The study, published in the American Journal of Preventive Medicine, examined outcomes for participants who engaged in one of two programs: an existing but untested exercise program (First Step to Active Health ©) and a nutrition program developed by the researchers (Steps to Healthy Eating).

The results indicated that the exercise program participants increased their physical activity significantly more than those who followed the nutrition program. However, both groups benefited from their programs in other areas that are important for people with arthritis. Regardless of their assigned program, participants experienced improvements in lower body strength and flexibility, functional exercise capacity, pain, fatigue, stiffness and confidence to manage arthritis symptoms.

“There is a substantial body of research showing that people with arthritis can benefit from exercise,” says Wilcox. “The real challenge is increasing exercise participation in this population.”

Unfortunately, most programs designed for people with arthritis are group-based and not always accessible. Consequently, the research team, which includes Arnold School colleagues Bruce McClenaghan and Marsha Dowda (exercise science) as well as Patricia Sharpe and Katherine Leith from the College of Social Work, determined that safe and effective home-based, self-directed programs are needed.

Both programs were previously untested by adults with arthritis, and both programs are step-based. For the exercise group, participants were advised to begin with aerobic exercise, and then add the other steps (i.e., flexibility, strength and balance exercises) one at a time.

“Our study shows that this particular self-directed exercise program appears safe for people with a wide variety of types of arthritis and appears effective at increasing physical activity and improving arthritis-related symptoms,” Wilcox says.

Self-directed programs also offer greater flexibility for those without access to group-based programs or those who prefer to exercise on their own. Further, these programs have greater potential for low-cost dissemination, which the team believes is an important next step in this research. They recommend identifying methods for how to disseminate this program and its benefits to people with arthritis throughout community settings and clinical practices. 

The Centers for Disease Control and Prevention (CDC) provided funding for the study, which was conducted through the Arnold School’s Prevention Research Center. Directed by Wilcox, the Center promotes physical activity by sponsoring projects that encourage people of all ages to become more physically active. It is one of 26 university-based centers conducting applied research and practice in chronic disease prevention and control as part of the Prevention Research Centers Program of the CDC.

Co-authors on the study include Bruce McClenaghan and Marsha Dowda (Arnold School of Public Health, University of South Carolina), Patricia Sharpe and Katherine Leith (College of Social Work, University of South Carolina), Meghan Baruth (Department of Health Science, Saginaw Valley State University) and Jennifer M. Hootman (Division of Population Health, Centers for Disease Control and Prevention).