UIC study examines exercise and weight loss for older adults with osteoarthritis

The University of Illinois at Chicago has been awarded a $3 million grant to study the effectiveness of two community-based health promotion programs for older adults with osteoarthritis.

The research is funded by the National Institute on Aging.

The study will compare Fit and Strong!, an evidence-based physical activity and health behavior change program, with Fit and Strong! Plus, the traditional program with an added weight management/dietary component.

Fit and Strong! has proven effective for older adults with osteoarthritis, the most common chronic condition and the primary cause of disability in older adults.

Fit and Strong! can improve joint stiffness, pain and function, anxiety/depression, lower extremity strength and gait speed and enhance maintenance of physical activity in older adults for up to 18 months, said Susan Hughes, co-principal investigator of the project and co-director of the Center for Research on Health and Aging at UIC's Institute for Health Research and Policy.

While the traditional program has been very successful, we felt that we needed to address the underlying weight issues that cause or exacerbate lower extremity osteoarthritis, Hughes said.

In the new study, researchers will enroll 400 adults ages 60 and older with lower extremity osteoarthritis who have a body mass index of between 25 and 50. Half will be enrolled in Fit and Strong! and half in Fit and Strong! Plus.

Participants in Fit and Strong! Plus will participate in the traditional program and will also receive dietary and weight loss interactive sessions. The goal is to achieve a minimum 5 percent weight loss by increasing consumption of fruits and vegetables, decreasing saturated fats and sugar sweetened drinks, reducing overall calorie consumption, and learning to manage triggers that can lead to overeating.

The weight loss component is adapted from a successful weight loss trial funded by the National Cancer Institute that was conducted by Marian Fitzgibbon, co-principal investigator of the project and deputy director of UIC's Institute for Health Research and Policy.

Participants who are randomly assigned to Fit and Strong! Plus will learn strategies to increase their intake of fruits and vegetables and whole grains as well as monitoring their food intake. Participants will also learn more about what may be triggers for overeating and mindless eating that can contribute to weight gain, said Fitzgibbon, who is also professor of medicine in the UIC College of Medicine.

Fit and Strong! was developed by Hughes and is recommended by the Centers for Disease Control and Prevention and the Administration on Aging. The program is used at 54 sites in Illinois, North Carolina, West Virginia and Florida.

The program provides 60 minutes of exercise and 30 minutes of education three times a week for eight weeks.

The focus is on making exercises easy to do, developing individual routines, and reinforcing new behaviors, said Hughes, professor of community health sciences in the UIC School of Public Health.

The U.S. is spending billions of dollars on hip and knee replacements and there is an urgent need to develop effective and affordable solutions that can be implemented in the community, according to Hughes.

UIC researchers will partner with the Chicago Park District to conduct the study at three sites: Eckhart Park, Washington Park and Columbus Park. Nationally certified exercise instructors will be trained to conduct the programming.

All participants will be evaluated at two, six, 12, 18 and 24 months. The researchers will assess dietary changes, weight loss, exercise participation, measurement of osteoarthritis symptoms, anxiety and depression.

The researchers will also analyze Medicare claims data for participants before and after the intervention to evaluate health care use and cost.

Co-investigators are Carol Braunschweig, Richard Campbell, H. Justina Chang, Pankaja Desai, Gail Huber, and Denise Hynes of UIC.

The project is supported by grant number 1R01AG039374 from the National Institute on Aging.