Exercise can improve outcomes in subjects with osteoarthritis (OA), including pain reduction. However, pain can limit adherence to exercise prescriptions. This investigation was conducted as part of a study that examined the relationship between exercise adherence to an eight-week, home-based, muscle strength-training program and improvements in pain, muscle strength, and proprioception in subjects with OA of the knee. Secondary analysis was used to examine the impact of pain on the exercise intervention. The study used a pre-test post-test design and was guided by the Interaction Model for Client Health Behavior. A purposive sample of 39 subjects with OA was recruited. Pain, exercise self-efficacy, quadriceps muscle strength and proprioception were assessed at baseline and post-intervention. Physical examinations, knee radiographs, and instructions of three strengthening exercises were given to subjects at the first visit. During eight weeks of home exercise, subjects completed an exercise diary in which they recorded the amount of exercise performed, problems with exercises, use of weights, and pain level before, during, and after exercise. Pain improved significantly (48%) from baseline to post-intervention. There was a negative correlation between severity of pain at baseline and total adherence rate (r=.47, p=.029). Higher levels of pain during exercise were associated with poorer adherence. Declining adherence over the study correlated with worsening pain (r=.33, p=.047). Pain was the most frequently cited problem with exercise. There were significant negative associations between severity of pain before and during exercise and higher rates of weight use during exercise. These findings have clinical significance for nurses prescribing exercise to people with OA. Aggressive pain control could result in fewer problems with exercise, higher adherence, and greater use of weights during exercise. This would lead to greater benefit from the exercise intervention.
Session #1223 - Graduate Student Poster Session
The 29th Annual MNRS Research Conference (April 1-4, 2005)