Author
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BAKER, KRISTIN - BOSTON U |
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NELSON, MIRIAM - HNRCA |
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FELSON, DAVID - BOSTON U |
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LAYNE, JENNIFER - HNRCA |
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SARNO, ROBERT - TUFTS U |
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ROUBENOFF, RONENN - HNRCA |
Submitted to: Journal of Rheumatology
Publication Type: Peer Reviewed Journal Publication Acceptance Date: 1/24/2001 Publication Date: 6/1/2001 Citation: BAKER, K.R., NELSON, M., FELSON, D., LAYNE, J., SARNO, R., ROUBENOFF, R. THE EFFICACY OF HOME BASED PROGRESSIVE STRENGTH TRAINING IN OLDER ADULTS WITH KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. JOURNAL OF RHEUMATOLOGY. 2001;28:1655-65) Interpretive Summary: Knee arthritis suffers that participated in a home-based strength training program reported a 36% improvement in pain versus only an 11% improvement in those that did not exercise. Those that strength trained also improved in their ability to do activities such as walking, climbing stairs and getting in and out of a chair. Muscle strength improved on average by 71% in the affected leg in the group that strength trained and was associated with the improvements in physical activities. Technical Abstract: Pharmacological treatment of depression in geriatric patients is often difficult. Although unsupervised exercise has been shown to benefit younger depressed patients, there is no evidence that unsupervised exercise can be used as a maintenance treatment for depression in elderly patients. Our aim was to test the feasibility and efficacy of unsupervised exercise as a long-term treatment for clinical depression in elderly patients. We studied 32 subjects (71.3ñ1.2 years of age, mean ñSE) in a 20-week, randomized, controlled trial, with follow-up at 26 months. Subjects were community-dwelling patients with major or minor depression or dysthymia. Exercisers engaged in 10 weeks of supervised weight-lifting exercise followed by 10 weeks of unsupervised exercise. Controls attended lectures for 10 weeks. No contact was made with either group after 20 weeks until final follow-up. Blinded assessment was made with the Beck Depression Inventory (BDI), the Philadelphia Geriatric Morale Scale, and Ewart's Self Efficacy Scale at 20 weeks and with the BDI and physical activity questionnaire at 26 weeks. Patients randomized to the exercise condition completed 18ñ2 sessions of unsupervised exercise during Weeks 10 to 20. The BDI was significantly reduced at both 20 weeks and 26 months of follow-up in exercisers compared with controls (p<.05-.001). At the 26- month follow-up, 33% of the exercisers were still regularly weight lifting, versus 0% of controls (p<.05). Unsupervised weight-lifting exercise maintains its antidepressant effectiveness at 20 weeks in depressed elderly patients. Long-term changes in exercise behavior are possible in some patients without supervision. |