Objective. Physical activity (PA) is recommended for osteoarthritis (OA) management to reduce pain and improve function. The purpose of this study was to objectively assess the level and pattern of PA in male and female knee OA patients to determine adherence to Centers for Disease Control and Prevention/American College of Sports Medicine and Exercise and Physical Activity Conference recommendations for PA. Methods. Early OA patients (n ‫؍‬ 255, 76% women, mean ؎ SD age 54.6 ؎ 7.1 years, mean ؎ SD body mass index 27.8 ؎ 4.3 kg/m 2 ) with Kellgren/Lawrence-defined grade II (no higher) radiographic OA in at least 1 knee wore an accelerometer for 6 -7 contiguous days. Light (LPA), moderate (MPA), and vigorous (VPA) PA intensities were defined as accelerometer recordings of 100 -2,224, 2,225-5,950, and >5,950 counts per minute, respectively. Results. Patients wore accelerometers for a mean ؎ SD of 6.8 ؎ 0.3 days and 13.8 ؎ 2.2 hours/day, and spent much more time (P < 0.001) in MPA (23.6 ؎ 17.2 minutes/day) than VPA (0.95 ؎ 3.5 minutes/day). Men spent significantly (P < 0.05) more time in all PA intensities than women. Only 30% of patients achieved recommended PA levels. The proportion of men (47%) achieving the recommendation was significantly (P ‫؍‬ 0.04) higher than women (24%). Conclusion. Knee OA patients accumulate little VPA and most (70%) do not achieve recommended levels for MPA or greater. New strategies to increase levels of PA in this population are needed.

Objective. To assess the relative effectiveness of combining self-management and strength training for improving functional outcomes in patients with early knee osteoarthritis. Methods. We conducted a randomized intervention trial lasting 24 months at an academic medical center. Communitydwelling middle-aged adults (n ‫؍‬ 273) ages 35-64 years with knee osteoarthritis, pain, and self-reported physical disability completed a strength training program, a self-management program, or a combined program. Outcomes included 5 physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and 2 self-reported measures of pain and disability.

Patients with early-onset OA of the knee can engage in an RT program without sacrificing their overall MVPA levels. These results support the value of RT for management of knee OA.

Objective The goal of this study was to explore the intra- and interpersonal consequences of swearing. Specifically, it investigated what implications swearing has for coping with and adjustment to illness. Methods The present project combined data from two pilot studies of 13 women with rheumatoid arthritis and 21 women with breast cancer. Participants wore the Electronically Activated Recorder (EAR), an unobtrusive observation sampling method that periodically records snippets of ambient sounds, on weekends to track spontaneous swearing in their daily interactions, and completed self-reported measures of depressive symptoms and emotional support. Results Naturalistically-observed swearing in the presence of others, but not alone, was related to decreases in reported emotional support and increases in depressive symptoms over the study period. Further, decreases in emotional support mediated the effect of swearing on disease-severity adjusted changes in depressive symptoms. Conclusion These exploratory results are consistent with the notion that swearing can sometimes repel emotional support at the expense of psychological adjustment. This is one of the first studies to examine the role of swearing, a ubiquitous but understudied psychological phenomenon, in a medical context.

Objective-This study tested the degree to which naturalistically observed sighing in daily life is a behavioral indicator of depression and reported physical symptoms (i.e. experienced pain and flare days) in rheumatoid arthritis (RA) patients.Design-Thirteen RA patients wore the Electronically Activated Recorder (EAR), an observational ambulatory assessment tool, for two weekends (Friday through Sunday) approximately one month apart. The EAR periodically recorded snippets of ambient sounds from participants' momentary environments (50 sec every 18 min). Sighs were coded from the sampled ambient sounds. Main Outcome Measures-Depression was assessed with the Center for EpidemiologicalStudies Depression Scale, and the Beck Depression Inventory. Pain during the past month was assessed with a 10-cm visual-analog scale, and number of flare days during the prior 6 months was reported.Results-Sighing was significantly and strongly related to patients' levels of depression and non-significantly and less strongly to their reported pain and number of flare days. Conclusion-The findings suggest that sighing can serve as an observable marker of depression in RA patients. Because of the small sample size, the findings should be considered preliminary. KeywordsAmbulatory Assessment; Ecological Momentary Assessment; Electronically Activated Recorder; Emotion Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder characterized by pain and destruction of peripheral joints. As with physical health, RA exacts a heavy toll on mental health. About forty percent of RA patients develop comorbid depression (Covic, Tyson, Spencer, & Howe, 2006), which tends to exacerbate disease activity and undermine health-related quality of life (Zautra et al., 2004). Because depression most immediately affects people's inner mood and cognitive landscape, it is often "invisible" to outsiders. Thus, depression's privacy can impede its early detection and thereby adequate treatment. These issues are compounded when the social stigma surrounding depression leads to patients intentionally hiding symptoms (NIMH, 2001 Sighing is a behavior that has been phenomenologically defined as "an obvious exaggerated exhalation of breath" (p. 366; Keefe & Block, 1982), and physiologically as a breath that is "at least 500 mL larger than the mean of the prior three breaths and at least 400 mL larger than the following breath" (Abelson et al., 2001; p. 589). As such, sighing is a subtle expression that is potentially detectable by the EAR. Despite its intuitive tie to constructs such as psychological distress and depression, it has so far received very little scientific attention. The scarce research that exists on sighing suggests that it is conceptually and empirically linked to negative affect (Roth, 2005;Wilhelm, Trabert, & Roth, 2001). Empirically, in-lab studies have found that panic disorder patients sigh significantly more often than control participants (e.g. Abelson, Weg, Nesse, & Curtis, 2001;Wilhelm et al., 2001), suggesting that sigh...