Improvement in functional capacity also did not relate to a better employment experience. More than 30% of the total participants retired early due to their arthritis. A wide range of adherence existed in the experimental group. Some participants joined a gym and trained three or more days each week, while some did not train at all. It is also not known whether they did any aerobic training.
The participants in the experimental group significantly improved their strength over the 24-month study. The increased muscle strength, however, did not improve functional performance according to the Valpar 9 test. The Valpar 9 test did not distinguish between participants with a low degree of disability, and is not recommended for use as a clinical tool. Also, functional performance is a combination of many factors, and it is important to participate in a well-balanced exercise program incorporating flexibility, strength, and aerobic training to improve fitness and functional capacity.