Fit and Strong!: bolstering maintenance of physical activity among older adults with lower-extremity osteoarthritis

Am J Health Behav. 2010 Nov-Dec;34(6):750-63. doi: 10.5993/ajhb.34.6.10.


Objectives: To compare the impact of negotiated vs. mainstreamed follow-up with telephone reinforcement (TR) on maintenance of physical activity (PA) after Fit and Strong! ended.

Methods: A multisite comparative effectiveness trial with repeated measures.

Results: Single group random effects analyses showed significant improvements at 2, 6, 12, and 18 months on PA maintenance, lower-extremity (LE) pain and stiffness, LE function, sit-stand, 6-minute distance walk, and anxiety/depression. Analyses by follow-up condition showed persons in the negotiated with TR group maintained a 21% increase in caloric expenditures over baseline at 18 months, with lesser benefits seen in the negotiated-only, mainstreamed-with-TR, and mainstreamed-only groups. Significant benefits of telephone dose were also seen on LE joint stiffness, pain, and function as well as anxiety and anxiety/depression.

Conclusions: The negotiated follow-up contract that Fit and Strong! uses, bolstered by TR, is associated with enhanced long-term PA maintenance and health outcomes.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Exercise Therapy / methods
  • Female
  • Health Behavior
  • Humans
  • Lower Extremity / physiopathology
  • Male
  • Middle Aged
  • Motor Activity*
  • Osteoarthritis / physiopathology
  • Osteoarthritis / psychology*
  • Osteoarthritis / therapy
  • Patient Compliance / statistics & numerical data*
  • Patient Dropouts / statistics & numerical data