Small to moderate effect sizes were observed regardless of whether the intervention included exercise .
OBJECTIVE To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis .
BACKGROUND Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function .
Comparison of two methods of conducting the Fit and Strong! program.
OBJECTIVE Fit and Strong ! is an award winning , evidence -based , multiple-component physical activity/behavior change intervention . It is a group- and facility-based program that meets for 90 minutes 3 times per week for 8 weeks ( 24 sessions total ) . We originally tested Fit and Strong ! using physical therapists ( PTs )  as instructors but have transitioned to using nationally certified exercise instructors ( CEIs ) as part of an effort to translate Fit and Strong ! into community-based setting s , and have tested the impact of this shift in instruction type on participant outcomes . METHODS We used a 2-group design . The first 161 participants to sequentially enroll received instruction from PTs . The next 190 sequential enrollees received instruction from CEIs .  All participants were assessed at baseline , at the conclusion of the 8-week Fit and Strong ! program , and at the 6-month followup . RESULTS We saw no significant differences by group on outcomes at 8 weeks or 6 months . Participants in both groups improved significantly with respect to lower-extremity strength , aerobic capacity , pain , stiffness , and physical function . Significant differences favoring the PT-led classes were seen on 2 of 5 mediators , self-efficacy for exercise and barriers adherence efficacy . Participant evaluations rated both types of instruction equally highly , attendance was identical , and no untoward health events were observed or reported under either instruction mode . CONCLUSION Outcomes under the 2 types of instruction are remarkably stable . These findings justify the use of CEIs in the future to extend the reach of the Fit and Strong ! program
Small to moderate effect sizes were observed regardless of whether the intervention included exercise .
OBJECTIVE To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis .
BACKGROUND Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function .