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Effect of Weight Maintenance on Symptoms of Knee Osteoarthritis in Obese Patients: A Twelve‐Month Randomized Controlled Trial
Author(s) -
Christensen Robin,
Henriksen Marius,
Leeds Anthony R.,
Gudbergsen Henrik,
Christensen Pia,
Sørensen Tina J.,
Bartels Else M.,
Riecke Birgit F.,
Aaboe Jens,
Frederiksen Rikke,
Boesen Mikael,
Lohmander L. Stefan,
Astrup Arne,
Bliddal Henning
Publication year - 2015
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22504
Subject(s) - medicine , osteoarthritis , randomized controlled trial , weight loss , visual analogue scale , randomization , regimen , confidence interval , physical therapy , obesity , surgery , alternative medicine , pathology
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.