A randomized trial found that video-based, telehealth-delivered exercise and weight loss programs with online educational support improved pain and function in people with knee osteoarthritis and overweight or obesity. The intervention that included a dietary component conferred modest additional pain and function benefits and led to substantial weight loss. The findings are published in Annals of Internal Medicine.
Osteoarthritis affects more than 32.5 million adults in the United States and is a major public health problem around the world. Knee osteoarthritis is commonly associated with overweight and obesity, which aggravate pain and disability, accelerate osteoarthritis progression, and increase the likelihood of requiring costly knee surgery. Scalable knee osteoarthritis programs are needed to deliver recommended education, exercise, and weight loss interventions.
Researchers from the University of Melbourne recruited 416 people with persistent knee pain to participate in the Better Knee, Better Me trial. Patients were randomly assigned to one of two 6-month telehealth-delivered programs, one with and one without dietary intervention, compared with an information-only control group. During the trial, participants in the intervention groups were provided support from physiotherapists and dietitians via Zoom and had a suite of educational resources available online. Those in the exercise plus diet group also received meal replacements so they could maintain a ketogenic, low calorie diet.
At 6 months, the researchers found that compared to control, participants in both programs had significant improvements in knee pain, physical function, and quality of life, which were maintained in the longer-term. Compared to the exercise only program, the combined exercise and diet program led to additional benefits – including a greater reduction in pain, greater improvements in physical function, lower use of pain medications, and an average weight loss of 22 lbs. over the 6-month program. According to the researchers, these findings suggest that telehealth programs represent potentially scalable and accessible ways for people with knee osteoarthritis to receive recommended interventions.
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Corresponding author: Kim L. Bennell, PhD please contact Lito Vilisoni Wilson at [email protected]