Exercise and Anxiety in Adults with Arthritis: An IVHet Meta-Analysis

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PROJECT SUMMARY/ABSTRACT The prevalence of anxiety has been shown to be almost twice as high as depression among adults with arthritis and other rheumatic diseases (AORD). One potential nonpharmacologic approach for reducing anxiety in adults with AORD is exercise, an intervention that is generally safe and appropriate for most persons with various types of AORD. However, the overall treatment effect as well as treatment-covariate interactions from different studies addressing the effects of community-based exercise on anxiety in adults with AORD has never been elucidated at the meta-analytic level. This is problematic because it prevents health professionals from providing evidence-based recommendations regarding a low-cost, readily available, nonpharmacologic intervention that is available to the vast majority of the general public. This proposed project aims to fill these gaps. Using a recently developed meta-analytic approach that has been shown to be more valid than existing approaches, the overall objective of this two- year investigator-initiated R01 competitive renewal application is to examine the randomized controlled trial literature over an approximate 30 year period in order to determine the effects of community-deliverable exercise (aerobic, strength, or both) on anxiety in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia, the three types of AORD in which the largest number of randomized controlled exercise intervention trials are available. The specific aims of this project are to (1) determine the overall effects of community-deliverable exercise on anxiety in adults with selected types of AORD, and (2) identify those factors associated with community-deliverable exercise-induced changes in anxiety among adults with selected types of AORD. The results of this first-ever project, conducted by a team of experienced investigators with proven success in exercise, meta-analysis, and arthritis, will provide evidence-based recommendations regarding the effects of community-deliverable exercise on anxiety in adults with osteoarthritis, rheumatoid arthritis and fibromyalgia. This will be new and important information regarding the treatment of adults with selected types of arthritis at the community level, an approach that has the potential for the greatest reach in fulfilling part of the mission of NIAMS, that is, the “treatment of arthritis and musculoskeletal and skin diseases”.