Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity: A Randomized Clinical Trial
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(2):10 JAMA. 2022 Dec 13;328(22):2242-2251.Exclusive Author Interview
What this means for my practice?
The results of this study demonstrate the effectiveness of diet & exercise for overweight osteoarthritis patients: diet & exercise provides a clinically meaningful improvement in pain levels, reduction in weight and circumference, and improved functional outcomes and physical quality of life. This study was limited by the >20% patient dropout over the study period (those who didn't completed the trial had more pain, higher weight, and were younger than those who completed the trial), the lack of radiographic outcomes, and the lack of generalizability due to the use of facilities and nutritional supplements provided at no cost to participants, which may not be feasible outside of a clinical trial.
Study Summary
Eight hundred and twenty-three (n=823) overweight/obese knee osteoarthritis patients ≥50 years or older were randomized to receive an 18-month diet & exercise program (n=414) or an attention control (n=409), delivered in a community-based setting. The primary outcome of interest was the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain score. Secondary outcomes of interest included body weight, waist circumference, WOMAC function, 6-minute walk test, pain medication use, and Short-Form 36 (SF-36) physical and mental subscores. All outcomes were assessed upon completion of the 18-month study. Results of this study found diet & exercise to result in a higher rate of clinically meaningful WOMAC pain score reduction vs. control. Body weight, waist circumference, WOMAC function score, 6-minute walk test, and SF-36 physical subscores were also superior in the diet & exercise group,
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