Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis
Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis
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DOI：
10.1002/art.21466
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发表时间：
2005-10-15
期刊：
影响因子：
--
通讯作者：
Messier, SP
中科院分区：
文献类型：
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作者：
Focht, BC;Rejeski, WJ;Messier, SP
Objective.研究超重和肥胖老年膝骨关节炎（OA）患者运动和饮食减肥干预后与运动相关的自我效能的变化，并确定自我效能和疼痛是否介导干预对运动任务表现的影响。关节炎、饮食和活动促进试验是一项为期18个月的单盲、随机、对照试验，比较了单独运动、单独饮食减肥、运动加饮食减肥和健康生活方式控制干预治疗316例超重或肥胖老年人症状性膝关节OA的效果。参与者在基线、6个月和18个月的试验期间完成了爬楼梯时间和6分钟步行距离、完成每个移动任务的自我效能和自我报告的疼痛的测量。对基线调整后的结果变化的协方差进行混合模型分析，结果表明，运动+饮食减肥干预对活动相关自我效能产生了更大的改善（P = 0.0035），爬楼梯（P = 0.0249）、6分钟步行能力（P = 0.00031）和疼痛（P = 0.09）。中介分析显示，自我效能和疼痛是运动+饮食减肥对爬楼梯时间有益影响的部分中介。运动+饮食减肥改善了与运动相关的自我效能;这些特定任务控制信念和自我报告疼痛的变化是运动+饮食减肥对爬楼梯性能的有益影响的独立部分介质。
Objective. To examine changes in mobility-related self efficacy following exercise and dietary weight loss interventions in overweight and obese older adults with knee osteoarthritis (OA), and to determine if self efficacy and pain mediate the effects of the interventions on mobility task performance.Methods. The Arthritis, Diet, and Activity Promotion Trial was an 18-month, single-blind, randomized, controlled trial comparing the effects of exercise alone, dietary weight loss alone, a combination of exercise plus dietary weight loss, and a healthy lifestyle control intervention in the treatment of 316 overweight or obese older adults with symptomatic knee OA. Participants completed measures of stair-climb time and 6-minute walk distance, self efficacy for completing each mobility task, and self-reported pain at baseline, 6 months, and 18 months during the trial.Results. Mixed model analyses of covariance of baseline adjusted change in the outcomes demonstrated that the exercise + dietary weight loss intervention produced greater improvements in mobility-related self efficacy (P = 0.0035), stair climb (P = 0.0249) and 6-minute walk performance (P = 0.00031), and pain (P = 0.09) when compared with the healthy lifestyle control intervention. Mediation analyses revealed that self efficacy and pain served as partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb time.Conclusion. Exercise + dietary weight loss results in improved mobility-related self efficacy; changes in these task-specific control beliefs and self-reported pain serve as independent partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb performance.