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Alternative models to support weight loss in chronic musculoskeletal conditions: effectiveness of a physiotherapist-delivered intensive diet programme for knee osteoarthritis, the POWER randomised controlled trial.
Allison, Kim; Jones, Sarah; Hinman, Rana S; Pardo, Jesse; Li, Peixuan; DeSilva, Anurika; Quicke, Jonathan George; Sumithran, Priya; Prendergast, Jodie; George, Elena; Holden, Melanie A; Foster, Nadine E; Bennell, Kim L.
Afiliação
  • Allison K; Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia kim.allison@unimelb.edu.au.
  • Jones S; Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
  • Hinman RS; Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
  • Pardo J; Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
  • Li P; Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia.
  • DeSilva A; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
  • Quicke JG; Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia.
  • Sumithran P; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
  • Prendergast J; Primary Care and Health Sciences, School of Medicine, Keele University, Keele, UK.
  • George E; Chartered Society of Physiotherapy, Chancery Exchange, London, UK.
  • Holden MA; Department of Surgery, Division of Clinical Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
  • Foster NE; Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia.
  • Bennell KL; Medibank Private, Melbourne, Victoria, Australia.
Br J Sports Med ; 58(10): 538-547, 2024 May 02.
Article em En | MEDLINE | ID: mdl-38637135
ABSTRACT

OBJECTIVES:

To determine if physiotherapists can deliver a clinically effective very low energy diet (VLED) supplementary to exercise in people with knee osteoarthritis (OA) and overweight or obesity.

METHODS:

88 participants with knee OA and body mass index (BMI) >27 kg/m2 were randomised to either intervention (n=42 VLED including two daily meal replacement products supplementary to control) or control (n=46 exercise). Both interventions were delivered by unblinded physiotherapists via six videoconference sessions over 6 months. The primary outcome was the percentage change in body weight at 6 months, measured by a blinded assessor. Secondary outcomes included BMI, waist circumference, waist-to-hip ratio, self-reported measures of pain, function, satisfaction and perceived global change, and physical performance tests.

RESULTS:

The intervention group lost a mean (SD) of 8.1% (5.2) body weight compared with 1.0% (3.2) in the control group (mean (95% CI) between-group difference 7.2% (95% CI 5.1 to 9.3), p<0.001), with significantly lower BMI and waist circumference compared with control group at follow-up. 76% of participants in the intervention group achieved ≥5% body weight loss and 37% acheived ≥10%, compared with 12% and 0%, respectively, in the control group. More participants in the intervention group (27/38 (71.1%)) reported global knee improvement than in the control group (20/42 (47.6%)) (p=0.02). There were no between-group differences in any other secondary outcomes. No serious adverse events were reported.

CONCLUSION:

A VLED delivered by physiotherapists achieved clinically relevant weight loss and was safe for people with knee OA who were overweight or obese. The results have potential implications for future service models of care for OA and obesity. TRIAL REGISTRATION NUMBER NIH, US National Library of Medicine, Clinicaltrials.gov NCT04733053 (1 February 2021).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Redução de Peso / Índice de Massa Corporal / Osteoartrite do Joelho / Obesidade Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Sports Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Redução de Peso / Índice de Massa Corporal / Osteoartrite do Joelho / Obesidade Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Sports Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Austrália