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Predictors of Adherence to Strength Training in Older Adults with Knee Osteoarthritis

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Introduction: Approximately 14 million people in the United States have symptomatic Knee Osteoarthritis. Although adherence to an exercise program has been shown to improve clinically meaningful outcomes, adherence to exercise in older adults with knee OA is relatively low. There is little research on predictors of adherence in this population. Purpose: The purpose of this study was to examine which variables were the strongest predictors of adherence over 18-months to the high and low strength training exercise interventions of the Strength Training for Arthritis Trial (START). Methods: START was a single-center, 18-month randomized controlled trial for older adults with Knee OA. Participants were randomized to one of three interventions: low intensity strength training, high intensity strength training, or an attention-based control group. Adherence was defined as the number of sessions attended divided by the number of sessions prescribed. Baseline associations between continuous predictors and adherence were tested using Pearson correlations, while t-tests were used for categorical predictors. A stepwise variable selection was used to identify a parsimonious subset of predictors. Results: There were 217 older adults (LO 65.3 ± 7.6 years, HI 66.3 ± 8.7 years) included in these analyses. Male gender, living with at least one other person, unilateral OA presence, being retired or disabled from work, older in age, and on a greater number of medications and supplements were significantly associated with attending more exercise sessions. Occupation status, negative affect, bilateral OA presence, PAT-D IADLs, and living alone were deemed significant predictors in the first model and confirmed by a second model. Conclusions: Adherence to exercise in patients with knee OA needs to be examined across a broad range of factors. The factors identified in this thesis can aid in developing effective adherence promoting strategies.
Talbert, Christian (author)
Mihalko, Shannon (committee chair)
Fanning, Jason (committee member)
Beavers, Daniel (committee member)
2021-06-03T08:36:12Z (accessioned)
2021-06-03T08:36:12Z (available)
2021 (issued)
Health and Exercise Science (discipline)
http://hdl.handle.net/10339/98816 (uri)
en (iso)
Wake Forest University
Predictors of Adherence to Strength Training in Older Adults with Knee Osteoarthritis

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