Diet and exercise is associated with small improvements in knee pain in osteoarthritis

1. Community-based diet and exercise education improved osteoarthritis-related pain scores in this randomized controlled trial.

2. Community-based diet and exercise regimens were more effective in lowering mean weight and mean waist environment compared to caution controls.

Evidence Rating Level: 1 (excellent)

Osteoarthritis (OA) is the most common cause of mobility and disability in the elderly. As patients with OA live symptom-free for an average of 26.1 years, optimizing treatment for OA may have a significant impact on the quality of life of this population. Although obesity has been identified as a modifiable risk factor for her OA, the efficacy of diet and exercise in relieving OA pain has not been demonstrated in community-based settings.

Conducted in the United States, this randomized controlled trial consisted of 823 patients aged 50 years or older (77% female), with knee OA, and overweight (classified as BMI ≥ 27) . Patients with symptomatic coronary artery disease, type 1 diabetes, and active cancer were excluded. 414 patients were randomly assigned to the intervention group and received face-to-face dietary counseling, dietary replacement supplements, and 60-minute group exercise sessions three days a week for 18 months. 409 patients were randomized to the control group and received face-to-face nutrition and health education, a total of 5 times. The primary outcome was the self-reported Western Ontario and McMaster University Osteoarthritis Index (WOMAC) knee pain score. Secondary endpoints measured included weight, waist circumference, WOMAC functional score, pain medication use, and quality of life score.

At 18 months follow-up, the intervention group had a statistically significant improvement in knee pain compared to the control group. Although it is unclear whether the observed differences in knee pain scores were clinically significant, more patients in the intervention group achieved clinically meaningful improvement in pain scores compared with the control group. The intervention group also showed significant improvements in secondary outcomes such as body weight and functional scores. However, as nutritional supplements and gym access were provided as part of the trial protocol, the feasibility of replicating this study and providing such an intervention as part of osteoarthritis care is unclear. is.

Click to read the JAMA Network study

Image: PD

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