The Effect of Weight Loss and Exercise on Knee Osteoarthritis
The Impact of Weight Loss and Exercise on Knee Osteoarthritis
研究概览
详细说明
Knee OA is a major public health challenge affecting millions of people in the United States. Obesity is a primary target for intervention since it accounts for up to 30% of knee OA, exacerbates symptoms, and is associated with bilateral involvement and more rapid progression of the disease. While the American College of Rheumatology (ACR) Practice Guidelines recommend modest weight loss as symptomatic therapy, no published clinical trials have investigated the impact of weight loss on knee OA.
Physical activity has also been associated with pain reduction and increased mobility in individuals with knee OA and the ACR Practice Guidelines indicate that it should be included in treatment. Exercise may be especially helpful for overweight persons with knee OA as it is a potent predictor of weight loss maintenance. Though adherence to traditional exercise programs has been poor, adopting lifestyles in which exercise is accumulated throughout the day appears to be a promising new approach to physical activity. Lifestyle exercise may enhance exercise adherence by increasing options to be active and reducing time barriers. Episodic physical activity may also be preferable to continuous exercise by reducing pain and avoiding injury. The primary objective of this proposal is to evaluate the impact of weight loss and lifestyle exercise on knee osteoarthritis.
Participants will be randomly assigned to either a behavioral weight loss and exercise program or a delayed intervention group. Participants in the behavioral weight loss and exercise group will attend weekly group meetings at the Johns Hopkins Bayview Medical Center for 16 weeks. Group meetings last about 1 hour and are led by health care professionals. Participants will be taught how to lose weight and keep weight off by changing what they eat and evaluating their lifestyle. Participants will be instructed on a safe and effective diet plan (1200 calories/day for women; 1500 calories/day for men) and will be asked to increase their physical activity to about 30 minutes per day of brisk walking, most days of the week. After the 16-week program, groups will continue to meet every three months for 1 year to help sustain lifestyle changes.
The delayed intervention group will receive the program described above after a 4-month waiting period.
The primary outcome measure will be knee pain. Secondary measures include physical disability, quality of life, performance measures, and long-term adherence to behavior change.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Maryland
-
Baltimore、Maryland、美国、21224
- Johns Hopkins Bayview Medical Center
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria
- Knee arthritis
- Pain on > 50 % of days in the month in one or both knees
- Difficulty with activities of daily living due to knee pain
- X-ray documenting knee OA within 1 year prior to study entry
- 15 lbs to 50 lbs overweight
Exclusion Criteria
- Significant cardiac, pulmonary, renal, or hepatic disease
- Major psychiatric disease
- ACR functional class IV
- Structured exercise more than once per week for 20 minutes or longer during the 3 months prior to study entry
- Anticipates moving from the area within 18 months of study entry
- Anticipates undergoing knee surgery within 1 year of study entry
- Weight loss of more than 5 kg (11 lbs) in 3 months prior to study entry
- Anorexiant or other medications known to affect metabolism
- Current or planned pregnancy
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:阶乘赋值
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:1
16 weekly educational meetings
|
16 weekly educational meetings vs. waitlist control
|
无干预:2
Wait list control
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Pain
大体时间:4 months and 16 months
|
4 months and 16 months
|
合作者和调查者
调查人员
- 首席研究员:Susan J. Bartlett, MD、Johns Hopkins University
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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