Fit & Strong!®

Evidence-level

Description

Osteoarthritis (OA) is a chronic condition that often causes progressive functional limitations and contributes to additional medical conditions in older adults. However, research has proven that arthritis-associated muscle weakness and endurance can be minimized or reversed with regular exercise. As a program geared to address those latter challenges, Fit & Strong!® was developed to improve mobility and maintain independent functioning for older adults with lower extremity OA. The program combines 2 components shown effective for OA-related limitations: physical activity and behavioral health education.

The Fit & Strong! Program design focuses on physical activity and behavior changes for older adults. With research documenting ease of program replication and high retention and attendance rates of participants, the program consists of twenty-four 90-minute sessions. The first 60 minutes focus on safe stretching, balance, and aerobic and strengthening exercises to gradually increase in frequency, duration, and intensity over time. The last 30 minutes leverage the program's structured curriculum to provide health education and involve group problem solving in order for participants to develop their own home-based personal exercise routines, another sustainable hallmark of the program.

The program received national endorsement in 2017 when the National Council on Aging approved the program as an evidence-based fall prevention approach. By August 2020, the program was offered in many locations throughout 32 states — including rural communities.

Additionally, the original curriculum was expanded into another program, the Fit & Strong!Plus. This expansion, too, is backed by research documenting its effectiveness for adults dealing with issues related to excess weight and includes interventions proven successful in prior studies, such as physical activity and weight management.

In response to the changes in group activities related to the COVID-19 pandemic, the program was modified to offer a virtual home-based program version, called Fit & Strong!@Home. With its curriculum accessible by laptops, tablets, and smart phones, fitness sessions are Zoom-based and exercise demonstrations are also available through video. Additional curriculum materials and community building resources are also available online.

Fit & Strong! also offers online instructor training for new instructors. The asynchronous online training consists of 5 modules and uses videos, slides, pictures, and interactive test questions. The online training can be taken by instructors anywhere they an internet connection is available.

Created by teams at the of Illinois at Chicago School of Public Health's Institute for Research and Health Policy, funding for the original program's development was provided by the Centers for Disease Control and Prevention, the National Institute on Aging, the Arthritis Foundation, and The Retirement Research Foundation.

Services offered

Fit & Strong! classes meet 3 times per week for 8 weeks or 2 times per week for 12 weeks (24 total sessions). The classes consist of a core of multi-component exercises that focus on:

• Flexibility
• Aerobic training
• Strength/resistance training
• Balance
• Health education and self-management for sustained behavior change
• Individualized health plans for post-class maintenance

Additionally, the program also includes warm-up and stretching/balance exercises combined with a group problem-solving component that has proven important in increasing participants' confidence in their ability to both exercise safely and remain motivated to continue a physically active lifestyle.

Before program completion, instructors and participants negotiate continued program adherence contracts that emphasize a lifestyle to includes three self-directed 1-hr exercise sessions per week.

Results

Published studies have demonstrated that Fit & Strong! participants will likely see these sustained improvements after 12-18 months with an 8-week course:

• Increased confidence in their ability to exercise safely with arthritis
• Increased participation in exercise
• Increased lower extremity strength and mobility
• Decreased lower extremity stiffness
• Decreased anxiety and depression

Originally designed using only physical therapists (PTs) as instructors, additional research found that certified exercise instructors (CEIs) provided similar outcomes for participants. CEIs are less expensive than PTs, and likely more available in rural areas, making Fit & Strong! easier to implement.

In addition to CEIs, individuals who are certified in comparable evidence-based exercise programs like A Matter of Balance and chronic disease self-management programs (CDSMP) can also be trained as Fit & Strong! Instructors.

Additional academic journal information is available for the program and its effectiveness.

Replication

For those interested in starting a Fit & Strong! program, a 12-page guide is available providing information including readiness assessments, instructor requirements, support resources, and quality assurance procedures.

Fit & Strong instructors must:

• Be certified by either a nationally recognized fitness organization or serve as a leader of another evidence-based exercise program
• Complete Fit & Strong! training and certification

Program costs will vary depending on space, instructor and equipment costs such as:

• Open area for walking, ideally with space to walk
• Chairs for participants
• Elastic exercise bands
• Adjustable ankle cuff weights
• Floor mats
• Fit & Strong! Instructor and Participant Manuals

The program is licensed by the University of Illinois. Fit & Strong! licenses are managed by UIC's Office of Technology Management (OTM). A template for license and pricing information is available.

Contact Information

Topics
Aging and aging-related services · Arthritis · Elderly population · Wellness, health promotion, and disease prevention

States served
National/Multi-State, Illinois

Date added
June 7, 2013

Suggested citation: Rural Health Information Hub, 2025 . Fit & Strong!® [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/726 [Accessed 20 November 2025]