Tag Archives: Obesity

Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients

ARTICLE:

Christensen R, Henriksen M, Leeds AR, et al. Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial. Arthritis Care Res (Hoboken). 2015 May;67(5):640-50. doi: 10.1002/acr.22504. (Original) PMID: 25370359

ABSTRACT

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), a knee-exercise program (E), or “no attention“ (C; control group).
METHODS: We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks` maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria.
RESULTS: Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41).
CONCLUSION: A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.// <![CDATA[

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Comments from Clinical Raters
General Internal Medicine-Primary Care(US  I don’t think this article meaningfully informs the conversation about weight and knee OA pain and function.
RheumatoloGY  This randomized trial showed that symptomatic improvement in knee osteoarthritis is achieved by weight loss in obese patients. In the one year following intensive weight loss, improvement is sustained regardless of whether diet control, knee exercises or no intervention is carried out. This underscores the importance of weight loss for obese patients with OA of the knees.
Special Interest – Obesity — Physician  Well designed research supporting need for major weight loss through diet combined with exercise to decrease knee pain in obese patients. Although not really new information, the study does a nice job of making clear this is the way to go.
Special Interest – Obesity — Physician  An interesting study to read and review, partly due to the surprising results in the control group. The reduction in VAS pain was modest, but statistically significant. The weight loss group was expensive at 1170 Euros.

Walking your dog helps you both lose weight

Owners and Pets Exercising Together: Canine Response to Veterinarian-Prescribed Physical Activity

Authors: Byers, Christopher G.; Wilson, Cindy C.; Stephens, Mark B.; Goodie, Jeffrey L.; Netting, F. Ellen; Olsen, Cara H.

Abstract:

Using a prospective, randomized, single-blinded clinical design, we enrolled dog owners (DOs) and their dogs presenting to a veterinary referral hospital in a two-phase trial to determine whether veterinarian-initiated counseling increases physical activity and leads to secondary health benefits for DOs and their dogs. In Phase I, self-reported health measures, height, and weight were assessed for DOs. Body condition scores (BCS) for their dogs were also determined. Owners of overweight and obese dogs (BCS > 6) were recruited for Phase II in which a baseline serum biochemical profile was obtained for DOs and dogs. Participants were randomly assigned to either a physical activity (PA) or standard care (SC) group. All DOs were provided a pedometer to determine their baseline daily step count. The PA group was counseled by a veterinarian using a standard scripted handout to encourage increased physical activity with their dogs. The veterinarian also reviewed common barriers to activity, encouraged increased levels of physical activity, and delivered a specific exercise prescription for the dog. The stated goal was for the DO to spend at least 30 minutes a day engaged in physical activity with their dog. All owners and dogs returned in three months, and biochemical and anthropometric measurements were taken again. Seventy-five DOs completed Phase I. At the completion of Phase I, 46 DOs enrolled in Phase II. Of these, 32 completed all required elements. For all participants with complete Phase I and Phase II data, there was a significant reduction in mean BCS (6.7 to 6.4; t (31) = 2.88, p = 0.007). BCS and weight decreased similarly in both groups. Glucose increased over time in the SC group but not in the PA group, yielding a significant mean group difference at followup (113 mg/dL vs. 103 mg/dL; p = 0.01). Based on our findings, both groups increased physical activity and BCS decreased significantly, and veterinarian-based counseling may have impacted these changes. No other significant biochemical changes were noted.