Background/Purpose: According to the 2020 American Health Ranking System, 26% of adults are physically inactive with a higher prevalence found in adults ages ≥65 years. Physical inactivity coupled with musculoskeletal conditions can result in poor health outcomes i.e., decreased pain tolerance, weak muscles, and stiff joints. These problems increase with age with nearly 75% of adults ages ≥65 years affected by musculoskeletal diseases. The COVID-19 pandemic resulted in significant disruption to daily living, social interaction, physical activity, and access to healthcare services. Under these conditions, physical inactivity was more prominent resulting to a potential decline of musculoskeletal function and health outcomes. To address these gaps, and ensure continued access to healthcare services, HSS pivoted from onsite to virtual exercise programming.

Methods: In March 2020, during the height of the pandemic, HSS shifted to 60-minute virtual exercise classes (Pilates, Yoga, and T’ai Chi) via Zoom. Our classes were targeted and structured to provide increased opportunity for physical activity, social interaction with others, and access to programs. We introduced a variety of low-intensity exercises conducted safely at home, increased frequency of exercise classes, and promoted dialogue among participants before classes begin. Program effectiveness was measured using pre/post online surveys assessing socio-demographics, and self-reported health outcomes i.e., pain intensity, pain interference with seven aspects of daily living (ADL), physical functioning, stiffness, fatigue, physical activity, and self-efficacy. A longitudinal analysis was conducted using regression models.

Results: Our virtual exercise classes reached 5,030 community members. Of those assessed (n=287), 61 participants who self-reported having a musculoskeletal condition were mostly females (98%) ages ≥60 years (83%) and Caucasian (88%). Overall, these participants reported a 9% decrease in pain intensity (p≤0.05), 14% decrease in pain interference with relations with others (p≤0.05), and 9% decrease in stiffness (p≤0.05) with every 6-week virtual exercise session. In a sub-sample of participants with self-reported musculoskeletal conditions that participated in classes at least 2x/week (n=17), results revealed a 18% decrease in pain intensity (p≤0.001), 13% decrease in stiffness (p≤0.001), 14% decrease in stiffness (p≤0.05), and decreased pain interference with six ADL – general activity (18%; p≤0.001), mood (14%; p≤0.05), walking ability (17%; p< 0.05), normal work (16 %; p≤0.01), sleep (18%; p≤0.05), and enjoyment of life (18%; p< 0.01) with every 6-week virtual exercise session.

Conclusion: Our targeted approach in implementing safe low-intensity virtual exercises proved to be successful. Results indicate that virtual exercise classes were effective in improving health outcomes and fostering social connectedness in participants with musculoskeletal conditions. Amid uncertainties caused by the pandemic, shifting to virtual programming increased overall reach, reduced the negative impact of isolation, and enabled those with musculoskeletal conditions have increased access to effective health programs.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/improving-health-outcomes-and-social-connectedness-through-virtual-exercise-programs-in-community-members-with-musculoskeletal-conditions/