Feasibility of exercise and weight management for people with hip osteoarthritis and overweight or obesity: A pilot study

Hall, Michelle; Spiers, Libby; Knox, Gabrielle; Hinman, Rana S; Sumithran, Priya; Bennell, Kim L

doi:10.1016/j.ocarto.2021.100174

Cited by 8 publications

(16 citation statements)

References 51 publications

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“…All participants will provide written informed consent. Due to the expected low risk of harm based on our pilot study [ 22 ], we have not planned a data safety monitoring committee. There is also no planned interim analysis or stopping guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…The interventions are based on a diet and exercise program developed by the researchers for people with knee OA [ 28 ], with input from various stakeholders, and are reported according to TIDIeR recommendations [ 29 ]. Clinical consultations are informed by the Behaviour Change Wheel [ 30 ] and based on research into exercise [ 28 , 31 ] and weight management [ 22 ] for hip and knee OA. Prior to the first consultation with the physiotherapist and dietitian, participants will complete a pre-consultation survey asking about their main problems and goals, brief history of their hip symptoms and other health issues and previous weight management if they are allocated to the weight loss and exercise group.…”

Section: Methodsmentioning

confidence: 99%

“…For each participant, dietitians will individualise a dietary intervention involving a ketogenic VLCD. Our pilot study using a ketogenic VLCD demonstrated high acceptability among people with hip OA [ 22 ]. Participants will be encouraged to lose at least 10% of their body weight.…”

Section: Methodsmentioning

confidence: 99%

“…Five percent weight loss is recommended for improvement in OA symptoms [ 8 ] albeit based on trials in knee OA but a dose response is apparent with greater benefits found for 10% or more weight loss. We have demonstrated that 10% weight loss is achievable in our pilot study using a ketogenic VLCD [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Importantly, in combination with exercise, using nutritionally complete meal replacement products is considered safe in adults aged up to 80 years or older [ 20 ]. A VLCD is perceived as acceptable to people with knee OA [ 21 ], and our pilot study in hip OA ( n = 18) demonstrated feasibility of a ketogenic VLCD and exercise intervention delivered remotely [ 22 ]. We observed an average of 10% [95% CI 8 to 12%] reduction in body weight at 3 months and no adverse events related to the diet program were reported [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

Hall

Hinman

Knox

et al. 2022

BMC Musculoskelet Disord

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Background Hip osteoarthritis (OA) is a leading cause of musculoskeletal pain. Exercise is a core recommended treatment. Despite some clinical guidelines also recommending weight loss for hip OA, there is no evidence from randomised controlled trials (RCT) to substantiate these recommendations. This superiority, 2-group, parallel RCT will compare a combined diet and exercise program to an exercise only program, over 6 months. Methods One hundred people with symptomatic and radiographic hip OA will be recruited from the community. Following baseline assessment, participants will be randomly allocated to either, i) diet and exercise or; ii) exercise only. Participants in the diet and exercise group will have six consultations with a dietitian and five consultations with a physiotherapist via videoconferencing over 6 months. The exercise only group will have five consultations with a physiotherapist via videoconferencing over 6 months. The exercise program for both groups will include prescription of strengthening exercise and a physical activity plan, advice about OA management and additional educational resources. The diet intervention includes prescription of a ketogenic very low-calorie diet with meal replacements and educational resources to support weight loss and healthy eating. Primary outcome is self-reported hip pain via an 11-point numeric rating scale (0 = ‘no pain’ and 10 = ‘worst pain possible’) at 6 months. Secondary outcomes include self-reported body weight (at 0, 6 and 12 months) and body mass index (at 0, 6 and 12 months), visceral fat (measured using dual energy x-ray absorptiometry at 0 and 6 months), pain, physical function, quality of life (all measured using subscales of the Hip Osteoarthritis Outcome Scale at 0, 6 and 12 months), and change in pain and physical activity (measured using 7-point global rating of change Likert scale at 6 and 12 months). Additional measures include adherence, adverse events and cost-effectiveness. Discussion This study will determine whether a diet intervention in addition to exercise provides greater hip pain-relief, compared to exercise alone. Findings will assist clinicians in providing evidence-based advice regarding the effect of a dietary intervention on hip OA pain. Trial registration ClinicalTrials.gov . Identifier: NCT04825483. Registered 31st March 2021.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

Hall

Hinman

Knox

et al. 2022

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

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Weight Loss Induced by Antiobesity Medications and All‐Cause Mortality Among Patients With Knee or Hip Osteoarthritis

Wei,

Hunter,

Lane

et al. 2023

Arthritis & Rheumatology

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ObjectiveThe current guidelines recommend weight loss for patients with overweight or obesity and knee or hip osteoarthritis (OA); however, there is a paucity of data on the relation of weight loss to death among patients with OA. We aimed to examine the relation of the rate of weight loss induced by antiobesity medications over one year to all‐cause mortality among patients with overweight or obesity and knee or hip OA.MethodsUsing the IQVIA Medical Research Database, we identified people with overweight or obesity and knee or hip OA. We emulated analyses of a hypothetical target trial to assess the effect of slow‐to‐moderate (2%–10%) or fast (≥10%) weight loss induced by the initiation of antiobesity medications within one year on all‐cause mortality and secondary outcomes over five years’ follow‐up.ResultsAmong 6,524 participants, the five‐year all‐cause mortality rates were 5.3%, 4.0%, and 5.4% for weight gain or stable, slow‐to‐moderate weight loss, and fast weight loss arms, respectively. Compared with the weight gain or stable arm, hazard ratios of all‐cause mortality were 0.72 (95% confidence interval [CI] 0.56–0.92) for the slow‐to‐moderate weight loss arm and 0.99 (95% CI 0.67–1.44) for the fast weight loss arm. We found dose–response protective effects of weight loss on incident hypertension, type 2 diabetes, and venous thromboembolism but a slightly higher risk of cardiovascular disease, albeit not statistically significant, in the fast rate of weight loss arm than in the weight gain or stable arm and no significant relations of weight loss to the risk of cancer.ConclusionIn this population‐based study, a slow‐to‐moderate, but not fast, rate of weight loss induced by antiobesity medications is associated with a lower risk of all‐cause mortality in people with overweight or obesity and knee or hip OA.image

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Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain

Field

Pourkazemi

et al. 2022

Nutr. Res. Rev.

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Dietary restriction of carbohydrate has been demonstrated to be beneficial for nervous system dysfunction in animal models and may be beneficial for human chronic pain. The purpose of this review is to assess the impact of a low-carbohydrate/ketogenic diet on the adult nervous system function and inflammatory biomarkers to inform nutritional research for chronic pain. An electronic data base search was carried out in May 2021. Publications were screened for prospective research with dietary carbohydrate intake <130g/day and duration of ≥2 weeks. Studies were categorised into those reporting adult neurological outcomes to be extracted for analysis and those reporting other adult research outcomes Both groups were screened again for reported inflammatory biomarkers. From 1548 studies there were 847 studies included. Sixty-four reported neurological outcomes with 83% showing improvement. Five hundred and twenty-three studies had a different research focus (metabolic n=394, sport/performance n=51, cancer n=33, general n=30, neurological with non-neuro outcomes n=12, or gastrointestinal n=4). The second screen identified 63 studies reporting on inflammatory biomarkers with 71% reporting a reduction in inflammation. The overall results suggest a favourable outcome on the nervous system and inflammatory biomarkers from a reduction in dietary carbohydrates. Both nervous system sensitisation and inflammation occur in chronic pain and the results from this review indicate it may be improved by low-carbohydrate nutritional therapy. More clinical trials within this population are required to build on the few human trials that have been done.

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Feasibility of exercise and weight management for people with hip osteoarthritis and overweight or obesity: A pilot study

Cited by 8 publications

References 51 publications

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

Effects of adding a diet intervention to exercise on hip osteoarthritis pain: protocol for the ECHO randomized controlled trial

Weight Loss Induced by Antiobesity Medications and All‐Cause Mortality Among Patients With Knee or Hip Osteoarthritis

Low-carbohydrate and ketogenic diets: a scoping review of neurological and inflammatory outcomes in human studies and their relevance to chronic pain

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