Evaluation of group and self-directed formats of the Arthritis Foundation's Walk With Ease Program

Leigh F Callahan, Jack H Shreffler, Mary Altpeter, Britta Schoster, Jennifer Hootman, Laura O Houenou, Kathryn R Martin, Todd A Schwartz

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68 Citations (Scopus)


OBJECTIVE: To evaluate the effects of a revised 6-week walking program for adults with arthritis, Walk With Ease (WWE), delivered in 2 formats, instructor-led group or self-directed.

METHODS: In an observational pre-post study design, 462 individuals with self-reported arthritis selected either a group format (n = 192) or a self-directed (n = 270) format. Performance and self-reported outcomes were assessed at baseline and at 6 weeks. Self-reported outcomes were assessed at 1 year. Adjusted mean outcome values for group and self-directed participants were determined using regression models, adjusting for covariates.

RESULTS: At 6 weeks, significant adjusted mean improvements (P < 0.05) were seen for nearly all self-report and performance measures in both formats. Modest to moderate effect sizes (ES) were seen for disability (ES 0.16-0.23), pain, fatigue, and stiffness (ES 0.21-0.40), and helplessness (ES 0.24-0.28). The Arthritis Self-Efficacy (ASE) pain and symptom scales had modest improvements (ES 0.09-0.21). The performance measures of strength (ES 0.29-0.35), balance (ES 0.12-0.36), and walking pace (ES 0.12-0.32) all showed modest to moderate improvements. No adverse events were reported for either format. At 1 year, both formats showed modest improvement in ASE pain, but there were 5 outcomes where self-directed participants showed significant improvement, while the group participants did not.

CONCLUSION: The revised WWE program decreases disability and improves arthritis symptoms, self-efficacy, and perceived control, balance, strength, and walking pace in individuals with arthritis, regardless of whether they are taking a group class or doing the program as self-directed walkers. At 1 year, some benefits are maintained, particularly among the self-directed. This is a safe, easy, and inexpensive program to promote community-based physical activity.

Original languageEnglish
Pages (from-to)1098-1107
Number of pages10
JournalArthritis Care & Research
Issue number8
Publication statusPublished - Aug 2011

Bibliographical note

Copyright © 2011 by the American College of Rheumatology.


  • aged
  • arthritis
  • attitude to Health
  • behavior therapy
  • exercise therapy
  • humans
  • longitudinal studies
  • middle aged
  • patient compliance
  • program evaluation
  • psychotherapy, group
  • self care
  • self efficacy
  • treatment outcome
  • walking


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