Physical Therapist-Based Group Exercise/Education Program to Improve Functional Health in Older Health Maintenance Organization Members with Arthritis

Abstract

Purpose: The purpose of this research was to investigate the effects of a group education/low to moderate intensity exercise intervention on the health status of older health maintenance organization (HMO) members with arthritis. Methods: 36 individuals (11 males, mean age = 76.8 ± 5.1 yrs; 25 females, mean age = 71.8 ± 6.4 yrs) with moderate to severe osteoarthritis or rheumatoid arthritis participated in the study. Participants had multiple comorbidities (mean =1.8 ± 1.0) and were taking multiple medications (mean = 4.2 ± 2.1). Participants were pretested and post-tested using the Physical Performance Test (PPT) and the Short Form (SF)-36 health status questionnaire. The intervention consisted of 90-minute classes held twice weekly for 9 weeks. The classes encompassed arthritis education and an exercise program (stretching, strengthening, endurance, and balance). Standing and sitting dynamic balance exercises were emphasized, including use of large therapy balls in sitting. Results: The PPT mean total scores improved significantly from pretest to post-test (p < .001). Scores on 7 of 9 PPT items improved significantly (p < .05). Scores improved on all 8 SF-36 scales, but the changes did not reach significance (p > .05) on the physical component scales. Significant improvement occurred on 3 of 4 of the mental health component scales of the SF-36 (p < 05). Conclusion: A group program of education and exercise led by physical therapists and an arthritis educator had a positive impact on physical performance and mental health in older persons with arthritis. The class may be a worthwhile adjunct to medical management of patients with arthritis.