Self-Directed Exercise Program for Adults With Arthritis

• Symptoms of arthritis [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Visual numeric scales to assess pain, fatigue, and stiffness
• Lower body strength [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The 30-second chair stand will assess lower body strength.
• Functional exercise capacity [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The six-minute walk will assess functional exercise capacity
• Flexibility [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The sit-and-reach test will assess flexibility
• Physical activity [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) Questionnaire will assess physical activity participation
• Arthritis management self-efficacy [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The Arthritis Self-Efficacy Scale will assess confidence in managing arthritis symptoms

• Disability [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The Health Assessment Questionnaire (HAQ) will assess disability
• Upper body strength [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The grip strength test (kg/lbs of force) will assess upper body strength
• Balance [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Postural sway will be measured with the AMTI force platform to determine COP displacement, COP velocity, and 95th eclipse
• Gait [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  GAITRite will assess components of gait including cadence, step time, cycle time, step length, stride length, and velocity
• Depressive symptoms [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The short form of the Center for Epidemiological Studies Depression scale (CES-D) will assess depressive symptoms

• Disability [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The Health Assessment Questionnaire (HAQ) will assess disability
• Upper body strength [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The grip strength test (kg/lbs of force) will assess upper body strength
• Balance [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Postural sway will be measured with the AMTI force platform to determine COP displacement, COP velocity, and 95th eclipse
• Gait [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  GAITRite will assess components of gait including cadence, step time, cycle time, step length, stride length, and velocity
• Depressive symptoms [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  The short form of the Center for Epidemiological Studies Depression scale (CES-D) will assess depressive symptoms
• Disability [ Time Frame: 9 months ] [ Designated as safety issue: No ]
  The Health Assessment Questionnaire (HAQ) will assess disability
• Upper Body Strength [ Time Frame: 9 months ] [ Designated as safety issue: No ]
  The grip strength test (kg/lbs of force) will assess upper body strength
• Balance [ Time Frame: 9 months ] [ Designated as safety issue: No ]
  Postural sway will be measured with the AMTI force platform to determine COP displacement, COP velocity, and 95th eclipse
• Gait [ Time Frame: 9 months ] [ Designated as safety issue: No ]
  GAITRite will assess components of gait including cadence, step time, cycle time, step length, stride length, and velocity
• Depressive symptoms [ Time Frame: 9 months ] [ Designated as safety issue: No ]
  The short form of the Center for Epidemiological Studies Depression scale (CES-D) will assess depressive symptoms

The purpose of this study is to examine the effectiveness and safety of a self-directed physical activity program relative to a self-directed dietary program in adults with arthritis. A process evaluation will also be conducted to examine program reach, participation/dose, fidelity, and participant compatibility/satisfaction.

• Arthritis
• Osteoarthritis
• Rheumatoid Arthritis
• Fibromyalgia

• Behavioral: Multicomponent exercise
  This intervention is a self-directed, multicomponent, exercise intervention. Participants exercise on their own and follow a progressive stepped program that occurs in the following order: cardiorespiratory exercises, flexibility exercises, strength (upper and lower body) exercises, and balance exercises. Participants also complete a daily log of their exercises and return the logs every week for 12 weeks. The active intervention phase is 12 weeks.
• Behavioral: Nutrition
  This arm is a self-directed nutrition intervention. Participants follow a progressive stepped program that occurs in the following order: fruits, vegetables, grains, meat and beans. Participants also complete a daily log of their dietary intake and return the logs every week for 12 weeks. The active intervention lasts for 12 weeks.

• Experimental: Multicomponent exercise
  This arm is a self-directed, multicomponent, exercise intervention. Participants exercise on their own and follow a progressive stepped program that occurs in the following order: cardiorespiratory exercises, flexibility exercises, strength (upper and lower body) exercises, and balance exercises. Participants also complete a daily log of their exercises and return the logs every week for 12 weeks.
  Intervention: Behavioral: Multicomponent exercise
• Active Comparator: Nutrition
  This arm is a self-directed nutrition intervention. Participants follow a progressive stepped program that occurs in the following order: fruits, vegetables, grains, meat and beans. Participants also complete a daily log of their dietary intake and return the logs every week for 12 weeks.
  Intervention: Behavioral: Nutrition

Inclusion Criteria:

• Self-reported, health care provider-diagnosed arthritis (CDC definition)
• 18+ years of age
• Self-reported symptoms of joint pain, stiffness, tenderness, decreased range of motion, redness and warmth, deformity, crackling or grating, or fatigue
• Able to read and write in English

Exclusion Criteria:

• Another member of household is participating in study
• Plans to move from the Columbia, SC area in the next 9 months
• Unable to walk longer than 3 minutes without taking a rest
• Unable to stand without assistance for more than 2 minutes
• Cannot sit in a chair without arms for more than 5 minutes
• Measured resting blood pressure >160/100
• Positive response to PAR-Q question(s)
• Had a fall in the past year that required medical assistance
• Pregnant or breastfeeding
• Uses insulin to manage diabetes
• Participating in another research study that includes an intervention or drug
• Participates in 3+ days of structured moderate-intensity exercise for 30+ minutes per day
• Participates in 2+ days of strength building exercises for 20+ minutes per day