Exercise is a principal component of any arthritis self-management program. Callahan and coworkers evaluated the basic 8-week People with Arthritis Can Exercise (PACE) program for improvements in primary (symptoms, functioning, level of physical activity) and secondary (psychosocial) outcomes. A total of 346 individuals with self-reported arthritis from 18 sites participated in a randomized controlled trial of PACE. Outcomes were measured at baseline and at eight weeks. The intervention group completed self-reported assessments at 3 and 6 months. Multiple linear regression models were used to calculate adjusted outcome means in the intervention and control groups; a repeated-measures model was used to calculate adjusted means in the intervention group at 3 and 6 months. Both intent-to-treat (ITT) and as-treated (AT) analyses were conducted. Results showed that at 8 weeks, the intervention group showed improvements in the following outcomes: two symptom outcomes (pain, fatigue) and one psychosocial outcome (self-efficacy for managing arthritis) in the ITT analyses. One symptom outcome (pain), one function outcome (chair stands), and one psychosocial outcome (self-efficacy for arthritis management) were found in the AT analyses. In addition, those who attended more than 9 classes had improvements in three symptom outcomes (pain, fatigue, stiffness), two function outcomes (10-pound lifts, chair stands), and one psychosocial outcome (self-efficacy for arthritis management) at 8 weeks. Relative to baseline, PACE participants maintained significant improvements in symptoms at six months, but declined in function and self-efficacy for exercise.

VALUE OF STUDY TO READER: The authors concluded that if adults with arthritis attend a majority of PACE classes, they might expect improvements in symptoms, self-efficacy for arthritis management, and upper and lower extremity function. Achieving sustained improvement in outcomes may, therefore, require continued participation in PACE. This was an interesting study, but the conclusions are weak as no long-term data (over one year) were collected. It is hoped that a follow-up be conducted by the authors. It is difficult to justify the costs of such a study if such data are not gathered.

LF Callahan et al. A randomized controlled trial of the people with arthritis can exercise program: Symptoms, function, physical activity, and psychosocial outcomes. Arthritis & Rheumatology, 2007;59:92-101.