Not exercising at all? How about PACE?

Patient Expert

The People with Arthritis Can Exercise (PACE) Program, developed by the Arthritis Foundation, is a land-based program that helps people with rheumatoid arthritis incorporate exercise into their lives. Participants meet for 1 hour, twice a week for 8 weeks. The program is offered at fitness centers, churches, senior-centers and other community locations around the country. This exercise program is offered both at a basic level geared toward older adults who are generally sedentary and also at a more advanced level. The basic program focuses mostly on range-of-motion and low-resistance exercises. Instructors are trained by the Arthritis Foundation.

It sounds good, but is it effective? The PACE program has been around since 1987, but until recently, only a few small studies had tested the effectiveness of the program. Last month, researchers from the University of North Carolina at Chapel Hill, supported by the Centers for Disease Control and Prevention, published results of a study of the PACE basic program. The study followed 346 adults ranging in age from 32-94 (average age 70) who participated in PACE at various locations in North Carolina. The researchers included adults who self-reported having arthritis (either RA or OA), who were exercising very little and who's disease activity limited normal functioning.

The study found that for people who completed most of the program -- more than 9 sessions -- the program had a positive short term effect on pain and fatigue, improved upper and lower body strength and better self-management of arthritis. Six months after the program ended, participants were still reporting less pain and fatigue. Also, people who continued the program on their own reported lasting improvement in stiffness.

The researchers noted that most participants in the basic program did not show improvement in endurance and overall physical activity. However, they attributed this finding to the focus of the basic PACE program on range-of-motion and low-resistance exercise. Although not discussed in the article, perhaps the advanced program would have a significant impact on endurance and physical activity.

The researchers concluded that while the PACE program is safe and beneficial for older individuals with arthritis, more study is needed to determine whether offering the program more than twice per week and for longer periods would offer any additional benefits. They noted that all participants, even those who continued the program at home after the 8-week course, declined in self-efficacy for physical activity. They theorized that people may feel less confident without the class structure, frequency and social support. This isn't so different from other studies that have shown that people in general have a hard time maintaining fitness programs. For example, gyms see a huge surge of memberships in January when people want to take off the holiday weight, but by March, attendance drops significantly as people get bored or give up.

Have you tried a PACE program, aqua arthritis class or other exercise program geared toward people with arthritis? Was it effective for you? What would you recommend? Please share your thoughts.

For more information about exercise and rheumatoid arthritis, read:

Exercise is Part of a Healthy Lifestyle