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Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain.

OBJECTIVE: To examine the effects of aerobic and resistance exercise on self-efficacy beliefs in older adults with knee osteoarthritis (OA) and to determine whether self-efficacy and knee pain mediated the effects of the treatments on stair time performance and health perceptions. METHODS: Measures of self-efficacy, knee pain, stair climbing performance, and health perceptions were collected prior to randomization and again at an 18-month followup in older adults with knee OA who were assigned to 1 of 3 treatment conditions: aerobic exercise, resistance training, or health education control. All analyses were conducted on the intention-to-treat principle. RESULTS: Both exercise treatments increased self-efficacy for stair climbing in comparison to the health education control group. Both knee pain and self-efficacy mediated the effect of the treatments on stair climb time, whereas only knee pain mediated health perceptions. CONCLUSIONS: The findings suggest that control beliefs and changes in physical symptoms such as knee pain are important outcomes in physical activity programs with patients who have OA of the knee. Moreover, these variables mediate the effects that such programs have on disability and health perceptions.

Adult↗

Exercise therapy for anxiety and depression. 1. Does the evidence justify its recommendation?

Despite the ever-increasing importance placed on exercise in our society today, obtaining sufficient evidence to document its therapeutic role in anxiety and depression has proven to be a formidable task for researchers. A number of studies now provide evidence to justify the recommendation of moderate exercise to alleviate symptoms of anxiety and depression and to improve overall emotional well-being. For anxious or depressed patients, exercise produces a sense of mastery and control, and the positive effects of being successful in an exercise program spill over into other realms of their life.

Adult↗