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Improving Maintenance of Physical ACtivity Trial - Pilot (IMPACT-P)

Garver, Matthew J.
http://rave.ohiolink.edu/etdc/view?acc_num=osu1312202558

Abstract Details

2011, Doctor of Philosophy, Ohio State University, EDU Physical Activity and Educational Services.
Osteoarthritis (OA) is a chronic, degenerative disease afflicting millions of older adults. Knee OA (KOA), specifically, is a leading cause of functional limitation in aged persons. With multiple etiologies and no cure, strategies to mitigate progression, improve physical function and ameliorate pain symptoms are of utmost importance in helping patients to maintain functional ability and independence. Physical activity (PA) is an efficacious, adjuvant treatment approach that is highlighted in literature as having high-quality evidence for improving pain symptoms and increasing functional ability. Indeed, exercise interventions consistently result in clinically meaningful improvements in salient outcomes for KOA patients. Despite these established benefits, successfully promoting maintenance of regular PA participation remains a daunting challenge. PURPOSE: The purpose of the Improving Maintenance of Physical Activity Trial – Pilot (IMPACT-P), a single-blind, randomized controlled pilot trial, was to compare the efficacy of a traditional exercise training (TRAD) and a group-mediated cognitive-behavioral exercise intervention (GMCB) in producing increased physical activity participation, improving functional ability, increasing SE and improving pain symptoms in older, KOA patients. METHODS: Eighty KOA patients (M age = 63 years) were randomly assigned to GMCB (n = 40) or TRAD (n = 40) interventions. Self-reported (Community Health And Maintenance Program for Seniors) PA participation, accelerometer-determined (Lifecorder) PA participation, pain symptoms (Western Ontario McMasters University Osteoarthritis Index), functional ability (stair climb and 400-meter walk) and self-efficacy measures for stair climb and 400-meter walk performances were obtained at baseline and 3-month follow-up assessments. Analysis was completed with 2 (Treatment) x 2 (Time) ANCOVA controlling for age. RESULTS: The GMCB approach was found to result in significant improvements (both CHAMPS and Lifecorder) in short-term, moderate or greater intensity exercise participation (PAMod+) when compared with a TRAD exercise intervention approach receiving the same exercise prescription and equivalent contact hours. While performance outcomes were not different, subjects were more confident in their ability to complete the functional tasks at the 3-month time point. Of great importance, the TRAD and GMCB interventions promoted decreased pain symptoms after only 3-months of exercise engagement. CONCLUSION: When considered in aggregate, the present findings demonstrate that the GMCB intervention can result in similar improvements in pain symptoms and confidence for completing various functional tasks while promoting more favorable changes in short-term PAMod+ participation when compared with a standard exercise approach. Consequently, an exercise intervention designed to provide training and practice in activity-related behavioral self-regulatory skills may augment changes associated with exercise participation. Evidence from IMPACT-P serves to promote the GMCB approach as a valuable intervention strategy for the design and delivery of future interventions targeting the promotion of PA participation in older, KOA patients.
Steven Devor, PhD (Committee Co-Chair)
Brian Focht, PhD (Committee Co-Chair)
Kevin Hackshaw, MD (Committee Member)
Phyllis Pirie, PhD (Committee Member)
218 p.
Aging; Health; Health Sciences; Kinesiology; Physical Education; Physical Therapy; Public Health; Sports Medicine
Knee osteoarthritis; Exercise intervention; Older adults; Group-mediated cognitive-behavioral; Physical activity

Recommended Citations

Citations

  • Garver, M. J. (2011). Improving Maintenance of Physical ACtivity Trial - Pilot (IMPACT-P) [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1312202558

    APA Style (7th edition)

  • Garver, Matthew. Improving Maintenance of Physical ACtivity Trial - Pilot (IMPACT-P). 2011. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1312202558.

    MLA Style (8th edition)

  • Garver, Matthew. "Improving Maintenance of Physical ACtivity Trial - Pilot (IMPACT-P)." Doctoral dissertation, Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1312202558

    Chicago Manual of Style (17th edition)

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This open access ETD is published by The Ohio State University and OhioLINK.