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, W.H.; Burns, R.; Messier, S.P.; Applegate, W.; Rejeski, W.J.; Morgan, T.; Shumaker, S.; Berry, M.J.; O'Toole, M.; Monu, J.; Craven, T.
JAMA 277(1): 25-31
1997
ISSN/ISBN: 0098-7484 PMID: 8980206 Document Number: 476101
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 lt .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 lt .001), mean (+-SE) time to climb and descend stairs (12.7+-0.4 vs 13.9+-0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1+-0.2 vs 10.0+-0.1 seconds; P lt .001), and mean (+-SE) time to get in and out of a car (8.7+-0.3 vs 10.6+-0.3 seconds; P lt .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-minute 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.