Background/Purpose: An estimated 54 million US adults have arthritis, and more than half are not receiving the recommended physical activity (MMWR, 2018). Walk With Ease (WWE) is one of five evidence-based programs shown to improve physical activity and self-management in patients with arthritis (Callahan, 2011). However, WWE is not widely used in non-urban communities. The objectives of this study were to 1) implement WWE in a community YMCA fitness center, 2) examine physical function and self-reported health outcomes in patients with arthritis, and 3) examine the feasibility and sustainability of implementing WWE.

Methods: Brochures, flyers, and electronic health record referrals from a YMCA and one health system were used to recruit adults who self-identified with arthritis and met the program requirements of being able to stay on their feet for 10 minutes. A physical therapist and two Arthritis Foundation trained YMCA staff members conducted a total of six, 6-week sessions, meeting 3 days/wk between Aug 2016 and Dec 2018. Walking speed measurements and 2-minute step counts were performed at baseline and 6-week follow-up. Pre/post-surveys were distributed to all registered participants, including those who did not complete the program. Survey items (n=25) included a 10-point visual analogue scale for arthritis pain, mood, fatigue, and global health, a validated multi-dimensional health assessment questionnaire (MD-HAQ) and a weekly exercise plan. Results were compared using paired t-tests.

Results: Of 35 registered participants, 31 attended WWE (range 2-10 participants per session). Participants were predominately 65 years or older (78%), female (77%) and Caucasian (100%). All had pre- or post-data, while only 21 (67%) had paired data. In paired data, normal and fast walking speed increased an average of 0.53 ft/s (p=0.02) and 0.67 ft/s (p=0.01), respectively. 2-minute step count increased an average of 48.5 steps (p<0.01). MD-HAQ and pain scores improved an average of 2.84 (p<0.01) and 1.43 (p=0.01). Global health scores improved an average of 1.43 (p<0.01). Most participants (87%) reported plans to continue to exercise 2-3x/wk. Average program costs to YMCA ($208/participant) were comparable to a comprehensive physical therapy visit. Limitations include a small, single-center cohort with low diversity and inconsistent completion among participants.

Conclusion: Our pilot study showed that WWE improves physical function and self-reported health outcomes in patients with arthritis. In addition, WWE appears to be a feasible, sustainable, and cost effective program within non-urban community partners. Given observed improvements, health professionals should continue to emphasize the importance of physical activity, including community referrals. Future studies should examine how to increase provider referral of patients with arthritis to improve patient outcomes.