EFFECTIVENESS OF INTENSIVE DIET AND EXERCISE ON KNEE PAIN AMONG COMMUNITIES WITH KNEE OSTEOARTHRITIS, OVERWEIGHT, AND OBESITY: THE WE-CAN PRAGMATIC RANDOMIZED CLINICAL TRIAL
Authors: Messier S et al.
In this multicentre pragmatic, assessor-blinded, randomized controlled trial in community-dwelling, men and women aged ≥ 50 years with knee OA and overweight or obese (BMI ≥27) were randomly assigned to either an 18-month diet and exercise (D+E) intervention or an attention control (C).
Among the 823 randomized participants (mean age, 64.6 years; 637 (77%) women), 658 (80%) completed the trial. The difference in mean 18-month body weight between D+E and C was 10.9 kg (-10.8%) vs 2.7 Kg (-2.7%). In the primary study outcome, the mean 18-month WOMAC pain was significantly less for D+E vs C (4.9 vs 5.5). In the secondary outcomes the D+E showed also a significant difference in WOMAC function (16.4 vs 19.7), greater 6-minute walk distance (419 m vs 376 m) and greater SF-36 physical health related quality of life (41.3 vs 37.5) compared to the C group.
Among overweight or obese participants with knee OA 18-months of diet and exercise delivered in community settings significantly reduced weight and WOMAC knee pain compared to an attention control group. This community-based trial, which had few exclusion criteria due to its pragmatic design, resulted in reductions in weight and knee pain that were similar to previous academic, center-based efficacy trials of knee OA and weight loss. This study provides a blueprint for the implementation of a successful treatment for a pervasive public health problem in clinical and community settings.