Background and aims: Physical exercise is associated with a lower risk of disability. The impact of comorbidity on the benefits from physical exercise has not been clearly investigated. Elders with comorbidity may benefit from physical exercise to preserve physical function. Methods: Data are from 435 participants with knee osteoarthritis aged ≥60 years enrolled in the Fitness and Arthritis in Seniors Trial (FAST), who were randomly assigned to 18-month health educational (HE), weight training (WT), or aerobic exercise (AE) interventions. Comorbidity was defined as the presence of osteoarthritis and ≥2 clinical conditions. Percent changes in the 6-minute walk test, self-reported disability and knee pain from baseline to 3-, 9-, and 18-month follow-up visits were analyzed according to comorbidity, using analysis of variance. Significances were adjusted using the Bonferroni method. Results: Mean age of the sample was 68.7 years. In participants with comorbidity (n=197), those in the AE intervention showed significant improvement in walking speed, compared to WT and HE groups, since the beginning of follow-up. Subjects with comorbidity in AE and WT groups showed improvement of the disability score at the 3-month follow-up visit compared to those in the HE group. This improvement was maintained at the end of the follow-up by the only AE group compared to the HE one (p=0.06). In participants with comorbidity, the pain score was improved by the AE intervention. Conclusions: AE and WT interventions improve physical function in individuals with comorbidity. AE improves physical function and knee pain independently of the presence of comorbidity.
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Nagi SZ. An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc 1976; 54: 439–67.
Chan L, Beaver S, Maclehose RF, Jha A, Maciejewski M, Doctor JN. Disability and health care costs in the Medicare population. Arch Phys Med Rehabil 2002; 83: 1196–201.
Fried TR, Bradley EH, Williams CS, Tinetti ME. Functional disability and health care expenditures for older persons. Arch Intern Med 2001; 161: 2602–7.
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol 2004; 59: 255–63.
Fried LP, Guralnik JM. Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc 1997; 45: 92–100.
Fuchs Z, Blumstein T, Novikov I, et al. Morbidity, comorbidity, and their association with disability among community-dwelling oldest-old in Israel. J Gerontol 1998; 53: M47–55.
Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol 1999; 52: 27–37.
Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum 2003; 48: 3359–70.
Verbrugge LM, Lepkowski JM, Konkol LL. Levels of disability among U.S. adults with arthritis. J Gerontol 1991; 46: S71–83.
Ferrucci L, Izmirlian G, Leveille S, et al. Smoking, physical activity, and active life expectancy. Am J Epidemiol 1999; 149: 645–53.
LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol 1993; 137: 858–69.
Wu SC, Leu SY, Li CY. Incidence of and predictors for chronic disability in activities of daily living among older people in Taiwan. J Am Geriatr Soc 1999; 47: 1082–6.
Stessman J, Hammerman-Rozenberg R, Maaravi Y, Cohen A. Effect of exercise on ease in performing activities of daily living and instrumental activities of daily living from age 70 to 77: the Jerusalem longitudinal study. J Am Geriatr Soc 2002; 50: 1934–8.
Brach JS, Simonsick EM, Kritchevsky S, Yaffe K, Newman AB. The association between physical function and lifestyle activity and exercise in the health, aging and body composition study. J Am Geriatr Soc 2004; 52: 502–9.
Penninx BW, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med 2001; 161: 2309–16.
Meyer K, Schwaibold M, Westbrook S, et al. Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure. Am J Cardiol 1996; 78: 1017–22.
Oka RK, De MT, Haskell WL, et al. Impact of a home-based walking and resistance training program on quality of life in patients with heart failure. Am J Cardiol 2000; 85: 365–9.
Corvera-Tindel T, Doering LV, Woo MA, Khan S, Dracup K. Effects of a home walking exercise program on functional status and symptoms in heart failure. Am Heart J 2004; 147: 339–46.
Berry MJ, Rejeski WJ, Adair NE, Ettinger WH Jr, Zaccaro DJ, Sevick MA. A randomized, controlled trial comparing long-term and short-term exercise in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2003; 23: 60–8.
Ettinger WH Jr, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997; 277: 25–31.
Cesari M, Onder G, Russo A, et al. Comorbidity and physical function: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study). Gerontology 2006; 52: 24–32.
Ettinger WH Jr, Fried LP, Harris T, Shemanski L, Schulz R, Robbins J. Self-reported causes of physical disability in older people: the Cardiovascular Health Study. CHS Collaborative Research Group. J Am Geriatr Soc 1994; 42: 1035–44.
Fitti JE, Kovar MG. The Supplement on Aging to the 1984 National Health Interview Survey. Vital Health Stat 1987; 1: 1–115.
Rejeski WJ, Ettinger WH Jr, Schumaker S, James P, Burns R, Elam JT. Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthritis Cartilage 1995; 3: 157–67.
Chaudhry S, Jin L, Meltzer D. Use of a self-report-generated Charlson Comorbidity Index for predicting mortality. Med Care 2005; 43: 607–15.
Selim AJ, Fincke G, Ren XS, et al. Comorbidity assessments based on patient report: results from the Veterans Health Study. J Ambul Care Manage 2004; 27: 281–95.
Rostagno C, Olivo G, Comeglio M, et al. Prognostic value of 6-minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation. Eur J Heart Fail 2003; 5: 247–52.
Carter R, Holiday DB, Nwasuruba C, Stocks J, Grothues C, Tiep B. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest 2003; 123: 1408–15.
Harada ND, Chiu V, Stewart AL. Mobility-related function in older adults: assessment with a 6-minute walk test. Arch Phys Med Rehabil 1999; 80: 837–41.
Bean JF, Kiely DK, Leveille SG, et al. The 6-minute walk test in mobility-limited elders: what is being measured? J Gerontol 2002; 57: M751–6.
Rejeski WJ, Ettinger WH Jr, Shumaker S, et al. The evaluation of pain in patients with knee osteoarthritis: the knee pain scale. J Rheumatol 1995; 22: 1124–9.
Cress ME, Buchner DM, Questad KA, Esselman PC, deLateur BJ, Schwartz RS. Exercise: effects on physical functional performance in independent older adults. J Gerontol A Biol Sci Med Sci 1999; 54: M242–48.
Rooks DS, Kiel DP, Parsons C, Hayes WC. Self-paced resistance training and walking exercise in community-dwelling older adults: effects on neuromotor performance. J Gerontol 1997; 52: M161–8.
Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769–75.
Schnelle JF, MacRae PG, Giacobassi K, MacRae HS, Simmons SF, Ouslander JG. Exercise with physically restrained nursing home residents: maximizing benefits of restraint reduction. J Am Geriatr Soc 1996; 44: 507–12.
Meuleman JR, Brechue WF, Kubilis PS, Lowenthal DT. Exercise training in the debilitated aged: strength and functional outcomes. Arch Phys Med Rehabil 2000; 81: 312–8.
Ades PA, Bailor DL, Ashikaga T, Utton JL, Nair KS. Weight training improves walking endurance in healthy elderly persons. Ann Intern Med 1996; 124: 568–72.
Hauer K, Pfisterer M, Schuler M, Bartsch P, Oster P. Two years later: a prospective long-term follow-up of a training intervention in geriatric patients with a history of severe falls. Arch Phys Med Rehabil 2003; 84: 1426–32.
King MB, Whipple RH, Gruman CA, Judge JO, Schmidt JA, Wolfson LI. The Performance Enhancement Project: improving physical performance in older persons. Arch Phys Med Rehabil 2002; 83: 1060–9.
Latham NK, Bennett DA, Stretton CM, Anderson CS. Systematic review of progressive resistance strength training in older adults. J Gerontol 2004; 59: 48–61.
Rozzini R, Frisoni GB, Bianchetti A, Zanetti O, Trabucchi M. Physical Performance Test and Activities of Daily Living scales in the assessment of health status in elderly people. J Am Geriatr Soc 1993; 41: 1109–13.
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Mangani, I., Cesari, M., Kritchevsky, S.B. et al. Physical exercise and comorbidity. Results from the Fitness and Arthritis in Seniors Trial (FAST). Aging Clin Exp Res 18, 374–380 (2006). https://doi.org/10.1007/BF03324833
- physical exercise
- physical function