You can walk your way to less disability, reduced arthritis pain and increased balance and strength by taking part in a six-week walking program developed by the Arthritis Foundation, according to a recent study published online in Arthritis Care and Research.

The study evaluated the effectiveness of Walk With Ease, or WWE, a community-based walking program that works to motivate people to be physically active by focusing on strategies to help them meet goals, monitor their progress and take advantage of social support.

“I think why many people don’t walk with arthritis is they are concerned they will make their arthritis worse,” says lead author Leigh F. Callahan, PhD, a professor of medicine and social medicine at the Thurston Arthritis Research Center at the University of North Carolina at Chapel Hill.

The study looked at 462 people with arthritis who were recruited from 33 sites around North Carolina including churches, senior centers and community centers. Participants were asked to choose between two forms of the program; about 40 percent chose to be part of an instructor-led walking class that met three times a week for an hour, and nearly 60 percent opted to do a self-directed version that offered the Walk with Ease (Arthritis Foundation, 2009) workbook as a guide.

Researchers assessed the physical function of participants at the start of the program and after six weeks using five tests, including getting up from a chair, standing on one leg and stepping in place for two minutes. Participants in both groups reported modest to moderate improvement in their disability as well as in pain, fatigue, stiffness and helplessness scores. There were no reports of adverse effects.

“What we did that was unique was we had independent walkers – or people that were self-directed – and we showed equivalent findings in improvement in overall symptoms and disability [compared with the walking-class group],” Callahan explains.

Pain levels, for example, dropped in both groups by about eight points on a 100- point scale. “You’re talking about a 20 percent improvement in their pain level. That’s going to make a noticeable difference,” Callahan says.

One year after the study start, participants were still maintaining some of the improvements in their pain levels, especially those in the self-directed group. There were other improvements in self-report measures at one year as well including stiffness, self-efficacy and helplessness – improvements in all those areas were also maintained over one year.

Callahan explains that self-directed participants may have continued walking beyond the six-week program while group walkers may not have continued walking at the same intensity or frequency because they no longer had the group, from which they derived enjoyment and motivation. “The lower pain levels are probably maintained because the people are continuing to walk,” she says. “I think if you quit walking, you lose the benefits.”

Participants reported high satisfaction with the program. Ninety-two percent of the self-directed group and 100 percent of the walking class said they would recommend the program to a friend, and the majority of all participants said the program motivated them to be more active.

“It’s an easy program. It gives people a certain amount of control,” says Callahan. “You can see improvement easily in a walking program.” She adds that, anecdotally, many participants reported the added benefit of losing weight, although that wasn’t the focus of the study.

Callahan say this is good news for arthritis patients because the program offers a safe, easy and affordable way to engage in physical activity whether they live in an urban or rural setting, and whether they exercise in a group or alone.

Jonathan Chang, MD, a clinical associate professor of orthopaedics at the University of Southern California calls the study a good and valid one, but says more work still needs to be done.

“Further validation is needed from a larger body of work. In medicine, [what constitutes] proof is not ordinarily drawn from a single study, but usually derives from a series of studies that show that the original concept was not a statistical fluke,” Dr. Chang explains.

Still, he says, “Their recommendations are of value and can be utilized as a guide to helping people to improve their function and ability to walk if you have arthritis.”