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Fit & Strong!

  • Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
  • Intervention: An 8-week physical activity, behavior change, and falls prevention program geared to older adults with osteoarthritis.
  • Results: Participants gained confidence with increased exercise, lessened stiffness, improved joint pain and improved lower extremity strength and mobility.
Evidence-Based (About evidence-level criteria)

Fit & Strong Logo Osteoarthritis (OA) is a common chronic condition among older adults which limits physical activity and is a risk factor for related disabilities. Research has proven that arthritis-associated muscle weakness and endurance can be minimized or reversed with regular exercise. The Fit and Strong! program was developed to assist older adults with lower extremity OA to improve mobility and maintain independent functioning. The program combines two components shown effective for OA: physical activity and behavioral health education.

The Fit & Strong! design focuses on affordability, easy replication, and involves an eight-week physical activity/behavior change program for older adults.

As of June 2017, the program is offered in many locations throughout 12 states, including several rural communities.

Of additional note, in June 2017 the National Council on Aging also gave Fit & Strong the approval as a falls prevention program.

Services offered

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

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

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


Fit and Strong! participants will likely see these sustained improvements after 12-18 months after 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.

For more detailed information about program effectiveness:

  • Hughes, S.L., Seymour, R.B., Campbell, R.T., Huber, G., Pollak, N., Sharma, L., & Desai, P. (2006). Long-term impact of Fit and Strong! on older adults with osteoarthritis. The Gerontologist, 46(6), 801-14. Article Abstract
  • Seymour, R.B., Hughes, S.L., Campbell, R.T., Huber, G.M., & Desai, P. (2009). Comparison of two methods of conducting the Fit and Strong! program. Arthritis and Rheumatism, 61(7), 876-84. Article Abstract | Free Full-text
  • Hughes, S.L., Seymour, R.B., Campbell, R.T., Desai, P., Huber, G., & Chang, H.J. (2010) Fit and Strong!: bolstering maintenance of physical activity among older adults with lower-extremity osteoarthritis. American Journal of Health Behavior, 34(6), 750-63. Article Abstract | Free Full-text
  • Brady, T.J., Jernick, S.L., Hootman, J.M., Sniezek, J.E. (2009) Public health interventions for arthritis: expanding the toolbox of evidence-based interventions. Journal of Women's Health, 18(12),1905-17. Article Abstract

For those interested in starting a Fit and 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 a nationally recognized fitness organization or 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
  • Chairs for participants
  • Elastic exercise bands
  • Adjustable ankle weights
  • Floor mats
  • Fit & Strong! Instructor and Participant Manuals

The program is licensed by the University of Illinois, Chicago and licensing fees apply.

Contact Information
Andrew DeMott, Program Manager
Fit and Strong! Team
Aging and aging-related services
Elderly population
Wellness, health promotion, and disease prevention
States served
National/Multi-State, Illinois
Date added
June 7, 2013
Date updated or reviewed
August 21, 2017

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.