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?.

Public Health Relevance

/PUBLIC HEALTH RELEVANCE Anxiety is a major public health problem in adults with arthritis and is almost two times greater than depression. This proposed project is aimed at determining the effects of exercise (aerobic, strength, or both) on anxiety in adults with arthritis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR061346-04
Application #
9352268
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Wang, Yan Z
Project Start
2012-09-01
Project End
2019-08-31
Budget Start
2017-09-01
Budget End
2019-08-31
Support Year
4
Fiscal Year
2017
Total Cost
Indirect Cost
Name
West Virginia University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
191510239
City
Morgantown
State
WV
Country
United States
Zip Code
26506
Kelley, George A; Kelley, Kristi S; Callahan, Leigh F (2018) Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a systematic review with meta-analysis of randomised controlled trials. BMJ Open 8:e019138
Kelley, George A; Kelley, Kristi S; Callahan, Leigh F (2018) Aerobic Exercise and Fatigue in Rheumatoid Arthritis Participants: A Meta-Analysis Using the Minimal Important Difference Approach. Arthritis Care Res (Hoboken) 70:1735-1739
Kelley, George A; Kelley, Kristi S; Callahan, Leigh F (2018) Brief Report: Exercise and Anxiety in Adults with Arthritis and Other Rheumatic Diseases: Support for Evidential Value. Biomed Res Int 2018:2984671
Kelley, George A; Kelley, Kristi S (2018) Community-deliverable exercise and depression in adults with arthritis: Confirmatory evidence of a meta-analysis using the IVhet model. J Evid Based Med 11:51-55
Kelley, George A; Kelley, Kristi S; Callahan, Leigh F (2017) Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: a protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 7:e014957
Kelley, George A; Kelley, Kristi S (2016) Exercise Reduces Depressive Symptoms in Adults with Arthritis: Evidential Value. Med Sci Sports Exerc 48:607
Kelley, George A; Kelley, Kristi S (2016) Exercise reduces depressive symptoms in adults with arthritis: Evidential value. World J Rheumatol 6:23-29
Kelley, George A; Kelley, Kristi S (2016) Retrieval of Individual Participant Data for Exercise Meta-Analyses May Not Be Worth the Time and Effort. Biomed Res Int 2016:5059041
Kelley, George A; Kelley, Kristi S; Hootman, Jennifer M (2015) Effects of exercise on depression in adults with arthritis: a systematic review with meta-analysis of randomized controlled trials. Arthritis Res Ther 17:21
Kelley, George A; Kelley, Kristi S (2014) Effects of exercise on depressive symptoms in adults with arthritis and other rheumatic disease: a systematic review of meta-analyses. BMC Musculoskelet Disord 15:121