medwireNews: Overweight or obese people with knee osteoarthritis may benefit from a diet- and exercise-focused telehealth intervention, which researchers have shown can improve pain and function over 6 months.
Kim Bennell (The University of Melbourne, Victoria, Australia) and co-investigators explain that the exercise program included six videoconference sessions with a physiotherapist, during which participants were given self-management advice and behavioral counseling. They also received educational booklets plus exercise equipment and a physical activity monitor.
The dietary intervention involved an additional six consultations with a dietician who supported the participants in losing at least 10% of their bodyweight via a ketogenic very-low-calorie diet of approximately 800 calories/day with very low amounts of carbohydrates (<50 g) and adequate (but not high) protein intake. Once their target weight was achieved, participants transitioned to healthy eating under the dietician’s care.
The study included 414 people with knee osteoarthritis aged 45 to 80 years with a BMI of 28–40 kg/m2 who reported knee pain most days for at least 3 months and had average knee pain severity of at least 4 on an 11-point numeric rating scale (NRS) in the previous week.
As reported in the Annals of Internal Medicine, participants randomly assigned to receive the exercise intervention (n=172) had significantly greater improvements in pain and function than those assigned to a control group (n=67) who were only given access to a website containing information about osteoarthritis, therapeutic options, weight loss, exercise and physical activity, managing pain, and sleep.
Specifically, NRS pain scores fell by a significant 0.8 points more from baseline to 6 months in the exercise group than in the control group while WOMAC function scores fell by a significant 7.0 points more.
For individuals assigned to receive both the exercise and dietary interventions (n=175), the corresponding significant differences relative to the control group were 1.5 and 9.8 points, and the researchers note that this combined intervention was also significantly superior to exercise alone.
Individuals in both intervention groups also reported significantly greater improvements in quality of life and physical activity levels than those in the control group, while the diet and exercise program also resulted in greater weight loss and improved depressive symptoms versus control.
Bennell and co-authors note that the “[b]enefits of both programs were largely maintained at 12 months,” and that participants reported good adherence.
And they conclude that their “telehealth programs represent potentially scalable and accessible ways for people with knee osteoarthritis to receive core recommended interventions.”
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