 |
|
Physical Exercise and the Prevention of Disability in Activities of Daily Living in Older Persons With Osteoarthritis
Brenda W. J. H. Penninx, PhD;
Stephen P. Messier, PhD;
W. Jack Rejeski, PhD;
Jeff D. Williamson, MD, PhD;
Mauro DiBari, MD, PhD;
Chiara Cavazzini, MD;
William B. Applegate, MD;
Marco Pahor, MD
Arch Intern Med. 2001;161:2309-2316.
Background The prevention of disability in activities of daily living (ADL) may
prolong older persons' autonomy (older persons are defined in this study as
those aged  60 years). However, proved preventive strategies for ADL disability
are lacking. A sedentary lifestyle is an important cause of disability. This
study examines whether an exercise program can prevent ADL disability.
Methods A 2-center, randomized, single-blind, controlled trial was conducted
in which participants were assigned to an aerobic exercise program, a resistance
exercise program, or an attention control group. Of the 439 community-dwelling
persons aged 60 years or older with knee osteoarthritis originally recruited,
the 250 participants initially free of ADL disability were used for this study.
Incident ADL disability, defined as developing difficulty in transferring
from a bed to a chair, eating, dressing, using the toilet, or bathing, was
assessed quarterly during 18 months of follow-up.
Results The cumulative incidence of ADL disability was lower in the exercise
groups (37.1%) than in the attention control group (52.5%) (P = .02). After adjustment for demographics and baseline physical function,
the relative risk of incident ADL disability for assignment to exercise was
0.57 (95% confidence interval, 0.38-0.85; P = .006).
Both exercise programs prevented ADL disability; the relative risks were 0.60
(95% confidence interval, 0.38-0.97; P = .04) for
resistance exercise and 0.53 (95% confidence interval, 0.33-0.85; P = .009) for aerobic exercise. The lowest ADL disability risks were
found for participants with the highest compliance to exercise.
Conclusions Aerobic and resistance exercise may reduce the incidence of ADL disability
in older persons with knee osteoarthritis. Exercise may be an effective strategy
for preventing ADL disability and, consequently, may prolong older persons'
autonomy.
From the Sticht Center on Aging, Department of Internal Medicine, Wake
Forest University School of Medicine (Drs Penninx, Williamson, DiBari, Applegate,
and Pahor), and the Department of Health and Exercise Sciences, Wake Forest
University (Drs Messier and Rejeski), Winston-Salem, NC; and the Department
of Gerontology and Geriatrics, University of Florence and Azienda Ospedaliera
"Careggi," Florence (Dr DiBari), and the Section of Geriatrics, University
of Rome "Tor Vergata," Rome (Dr Cavazzini), Italy.
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2001;161(19):2388-2389.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Effect of Resistance Training on Functional Capacity and Quality of Life in Individuals with High and Low Numbers of Metabolic Risk Factors
Levinger et al.
Diabetes Care 2007;30:2205-2210.
ABSTRACT
| FULL TEXT
Chronic Disease and Lifestyle Transitions: Results From the Longitudinal Aging Study Amsterdam
van Gool et al.
J Aging Health 2007;19:416-438.
ABSTRACT
Physical Activity and Aging
STEWART
Ann. N. Y. Acad. Sci. 2005;1055:193-206.
ABSTRACT
| FULL TEXT
Angiotensin-Converting Enzyme Inhibition Intervention in Elderly Persons: Effects on Body Composition and Physical Performance
Carter et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1437-1446.
ABSTRACT
| FULL TEXT
Ottawa Panel Evidence-Based Clinical Practice Guidelines for Therapeutic Exercises and Manual Therapy in the Management of Osteoarthritis
Ottawa Panel Members et al.
ptjournal 2005;85:907-971.
ABSTRACT
| FULL TEXT
Angiotensin-Converting Enzyme Insertion/Deletion Genotype, Exercise, and Physical Decline
Kritchevsky et al.
JAMA 2005;294:691-698.
ABSTRACT
| FULL TEXT
Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review
Roddy et al.
Ann Rheum Dis 2005;64:544-548.
ABSTRACT
| FULL TEXT
Factors Associated With Recovery of Independence Among Newly Disabled Older Persons
Hardy and Gill
Arch Intern Med 2005;165:106-112.
ABSTRACT
| FULL TEXT
Muscle dysfunction versus wear and tear as a cause of exercise related osteoarthritis: an epidemiological update
Shrier
Br. J. Sports. Med. 2004;38:526-535.
ABSTRACT
| FULL TEXT
Activities of Daily Living Function and Disability in Older Adults in a Randomized Trial of the Health Enhancement Program
Phelan et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2004;59:M838-M843.
ABSTRACT
| FULL TEXT
EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT)
Jordan et al.
Ann Rheum Dis 2003;62:1145-1155.
ABSTRACT
| FULL TEXT
Effect of Improving Depression Care on Pain and Functional Outcomes Among Older Adults With Arthritis: A Randomized Controlled Trial
Lin et al.
JAMA 2003;290:2428-2429.
ABSTRACT
| FULL TEXT
Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention
Podichetty et al.
Postgrad. Med. J. 2003;79:627-633.
ABSTRACT
| FULL TEXT
Moderate-impact exercise is associated with decreased severity of experimental osteoarthritis in rats
Galois et al.
Rheumatology (Oxford) 2003;42:692-693.
FULL TEXT
Effects of Nurse Counseling on Walking for Exercise in Elderly Primary Care Patients
Dubbert et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2002;57:M733-740.
ABSTRACT
| FULL TEXT
|
