PREDICTION AND UTILIZATION OF ALTERNATIVE MOVEMENT ACTIVITIES BY PATIENTS WITH ARTHRITIS. Thelma J. Mielenz*1,2; Leigh F. Callahan2 1. Division of Physical Therapy, Univeristy of North Carolina , Chapel Hill, NC; 2. Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC PURPOSE: The purposes of this study were 1) to determine the set of factors that best predicts the probability of patients with arthritis and/or chronic joint symptoms to utilize alternative movement activities, and 2) to describe the use of the different alternative movement activities. BACKGROUNDS/SIGNIFICANCE: In 2002, some 18 million Americans participated in yoga and in 2000, approximately 5 million Americans utilized the Pilates method. Three peer-reviewed articles have reported the effectiveness of yoga for carpal tunnel syndrome, osteoarthritis, and rheumatoid arthritis of the hand. Tai chi has been shown to reduce falls in the elderly in clinical trials. Qi gong had benefits for subjects with fibromyalgia in a non-randomized trial. Many senior centers offer tai chi, yoga, and Feldenkrais. In other words, a large and growing number of Americans use some form of complementary alternative medicine, including movement techniques such as tai chi, yoga, Feldenkrais, or Pilates. Practitioners are incorporating these alternative movement activities into treatment and are recommending them for patients with an arthritis and/or chronic joint symptoms. SUBJECTS: During one month in the summer of 2001, consecutive adult patients were enrolled from 17 family practices that were dispersed across rural and urban areas in North Carolina. Family practice sites were selected on the basis of percentage of African-Americans served. 4887 participants completed the baseline survey. Individuals who indicated osteoarthritis, rheumatoid arthritis, fibromyalgia, or chronic joint symptoms (>3months) were selected for a this study and were sent a second survey. METHODS AND MATERIALS: This is a cross-sectional study design with surveys administered by mail and telephone. The baseline survey collected information on sociodemographic variables, health status, and common chronic conditions. The second survey contained arthritis specific measures and nine Complementary Alternative Medicine (CAM) use categories. Movement activity was one of these categories. ANALYSES: The outcome was whether patients reported using alternative movement activity for their arthritis and/or chronic joint symptoms. The full logistics regression model contained the following covariate variables: osteoarthritis, fibromyalgia, rheumatoid arthritis, education, age, gender, race, self-report of mental health and physical health, and appropriate interaction terms. RESULTS: 1078 participants completed the second survey and were considered to have arthritis and/or chronic joint symptoms. 244 of these patients reported using the following alternative movement activities: 1% used the Trager method, 3% used Qi Gong, 3% used the Pilates method, 5% used the Alexander method, 5% used the Feldenkrais method, 8% used Tai Chi, and 20% used yoga. The final model dropped age, gender, race and the interaction terms. Three variables significantly predicted the utilizations of movement activities, including: fibromyalgia [OR=1.7 (95% CI 1.04-2.9)], physical activity limitations [OR=1.6 (95% CI 1.1-2.3)], and more education [OR=1.2 (95% CI 1.0-1.3)]. For example, patients with arthritis and/or chronic joint pain symptoms with fibromyalgia have 1.7 times the odds of utilizing alternative movement activities compared to patients with arthritis and/or chronic joint symptoms without fibromyalgia. CONCLUSIONS: Fibromyalgia, physical activity limitations, and more education were predictive of alternative movement activity utilization in patients with arthritis and/or chronic joint symptoms. Yoga was the most frequently used alternative movement activity in this population. FUNDING SOURCE: Foundation for Physical Therapy AHRQ Grant No. R21HS13521 AHRQ Grant No. T32HS00032 and Centers for Disease Control and Prevention No. U481CCU409660 KEYWORDS: Epidemiology, Fibromyalgia, Osteoarthritis, Pilates, Yoga Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.