Seniors, Put Your Money Where Your Knee Is

How FAST can you decide which is a more cost-effective treatment for knee osteoarthritis? To help answer this question, researchers designed a FAST study: the Fitness and Arthritis Seniors Trial.

Information about cost-effective treatment is needed to help identify the best treatments and, ideally, to lower costs of medical care. Calculating the benefits of preventive treatment is a challenge, especially when trying to decide the monetary value of less pain, better movement, or longer life. This study measured the benefits of various types of treatment for knee osteoarthritis (OA), along with the costs for each treatment.

After screening nearly 5000 people, the authors included 439 seniors in the study. Participants were randomly placed in one of three groups. One group did only aerobic exercise. Another did only resistance exercises. The third group served as a control group and received only education. To begin, participants completed a questionnaire about their knee condition. Then they were scored in their ability to do various daily activities, such as a six-minute walk, going up and down stairs, lifting and carrying, and getting into and out of a car. They also reported their pain levels.

The aerobic and resistance exercisers did their first three months of training in the clinic. They continued doing their program at home for another 15 months. Aerobic exercisers warmed up, walked, and then did a cool down for a total of 60 minutes, three times each week. People doing resistance exercises worked their major muscle groups using nine different strengthening exercises for the upper and lower body. The control group received monthly education classes for three months, each lasting 1.5 hours. A nurse contacted each person in the education group at regular intervals over the next 18 months.

The same questionnaire, scored tests, and pain reports were completed after the test period. The findings showed that costs were slightly less for resistance training than aerobics. And both types of exercise cost less than the education format. Looking at the benefits that were gained for the amount of money spent, resistance training had a bigger effect on overall knee health compared to the other two groups.

Even though the differences were small between aerobic and resistance exercise, the authors conclude that “resistance training is more economically efficient than aerobic exercise in improving physical function, when self-reported disability and various measures of physical function are the outcome variables considered.”