Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: A twelve-month randomized controlled trial
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Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either Dietary support (D), knee-Exercise program (E), or Control (C) "no attention". Methods Randomized, two-phase, parallel-group trial. 192 obese participants with knee OA were enrolled; mean age 62.5 y, 81% women with a mean entry weight of 103.2 kg. In phase-1, all participants were randomly assigned to one of three groups and began a dietary regimen of 400-810 and 1250 kcal/d for 8+8 weeks to achieve a major weight loss. Phase-2: 52 weeks maintenance in one of three groups D, E, or C. Outcomes: Changes from randomization in pain on a 100 mm Visual Analogue Scale, weight, and response according to OMERACT-OARSI criteria. Results Phase-1 mean weight loss was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 [95% CI: 9.0;12.8] kg) than those in the E (6.2 [4.4;8.1] kg), and C (8.2 [6.4;10.1] kg) groups (ANCOVA: P=.002). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; C: 5.5 mm) with no difference between groups (ANCOVA: P=.98). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment, in D, E, and C groups, respectively; with no statistically significant difference in the number of responders (P=.41). Conclusion A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program. © 2014 American College of Rheumatology.
|Journal||Arthritis Care & Research|
|Number of pages||11|
|Publication status||Published - 2015|