دورية أكاديمية
Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity ; A Randomized Clinical Trial
| العنوان: | Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity ; A Randomized Clinical Trial |
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| المؤلفون: | Messier, Stephen P., Beavers, Daniel P., Queen, Kate, Mihalko, Shannon L., Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., DeVita, Paul, Hunter, David J., Newman, Jovita J., Quandt, Sara A., Lyles, Mary F., Jordan, Joanne M., Callahan, Leigh F. |
| المصدر: | JAMA ; volume 328, issue 22, page 2242 ; ISSN 0098-7484 |
| بيانات النشر: | American Medical Association (AMA) |
| سنة النشر: | 2022 |
| الوصف: | Importance Some weight loss and exercise programs that have been successful in academic center–based trials have not been evaluated in community settings. Objective To determine whether adaptation of a diet and exercise intervention to community settings resulted in a statistically significant reduction in pain, compared with an attention control group, at 18-month follow-up. Design, Setting, and Participants Assessor-blinded randomized clinical trial conducted in community settings in urban and rural counties in North Carolina. Patients were men and women aged 50 years or older with knee osteoarthritis and overweight or obesity (body mass index ≥27). Enrollment (N = 823) occurred between May 2016 and August 2019, with follow-up ending in April 2021. Interventions Patients were randomly assigned to either a diet and exercise intervention (n = 414) or an attention control (n = 409) group for 18 months. Main Outcomes and Measures The primary outcome was the between-group difference in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain score (range, 0 [none] to 20 [severe]; minimum clinically important difference, 1.6) over 18 months, tested using a repeated-measures mixed linear model with adjustments for covariates. There were 7 secondary outcomes including body weight. Results Among the 823 randomized patients (mean age, 64.6 years; 637 [77%] women), 658 (80%) completed the trial. At 18-month follow-up, the adjusted mean WOMAC pain score was 5.0 in the diet and exercise group (n = 329) compared with 5.5 in the attention control group (n = 316) (adjusted difference, −0.6; 95% CI, −1.0 to −0.1; P = .02). Of 7 secondary outcomes, 5 were significantly better in the intervention group compared with control. The mean change in unadjusted 18-month body weight for patients with available data was −7.7 kg (8%) in the diet and exercise group (n = 289) and −1.7 kg (2%) in the attention control group (n = 273) (mean difference, −6.0 kg; 95% CI, −7.3 kg to −4.7 kg). There were 169 serious ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1001/jama.2022.21893 |
| الإتاحة: | https://doi.org/10.1001/jama.2022.21893Test https://jamanetwork.com/journals/jama/articlepdf/2799405/jama_messier_2022_oi_220131_1670262083.82673.pdfTest |
| رقم الانضمام: | edsbas.73794D5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1001/jama.2022.21893 |
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