Intensive diet, exercise reduce pain and improve mobility in people with knee OA

According to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Chicago, weight loss combined with exercise reduces pain and improves mobility in people with knee osteoarthritis.

Study lead author, Stephen P. Messier, PHD, at Wake Forest University comments, "Long-term intensive diet and moderate exercise can improve mobility and reduce pain by as much as 50 percent."

Knee osteoarthritis is a common form of osteoarthritis and is caused by cartilage breakdown in the knee joint. Factors that increase the risk of knee osteoarthritis — including being overweight, age, injury or stress to the joints, and family history — can increase the risk of knee osteoarthritis.

Losing weight by monitoring diet is potentially one of the best treatments for controlling pain associated with knee OA. Researchers from Wake Forest University in North Carolina recently conducted a long-term study that evaluated the impact of weight loss with or without exercise in reducing pain caused by OA. The researchers also measured function and mobility in older, overweight adults with knee osteoarthritis.

The researchers conducted the Intensive Diet and Exercise for Arthritis trial that measured 454 overweight adults with pain caused by knee osteoarthritis. Participants were selected randomly to lose weight in 18-months by either diet restriction only, or combining dietary restrictions with exercise. These groups were compared to an exercising-only control group. The researchers set a weight loss goal for the diet groups of at least 10 percent of body weight and required the exercise groups to participate in one hour of low-to-moderate walking and resistance training three days a week. The researchers compared the changes between the groups after the 18 month trial.

A total of 399 participants, or 88 percent, completed the study. Researchers determined that 85 percent of all participants had bilateral knee OA. Average age was 65.6 - of which 72 percent were female and 81 percent were white. Weight loss results included 11.4 percent for the diet plus exercise group, and 9.5 percent for the diet only group. The exercise-only group lost 2.2 percent of their body weight.

Measures of pain, function, and mobility were all improved to a greater degree in the diet plus exercise group. The researchers concluded that intense weight loss coupled with exercise led to the greatest improvement in people with knee OA, with a reduction in pain by approximately 50 percent.

Dr. Messier further comments, "Clinicians can tell their patients that they will see marked improvement in pain and function in six months or less with intensive diet and exercise. Significant between-group differences, however, may not appear (between diet, exercise, and diet combined with exercise) until 18 months. This underscores the need for long-term studies to detect clinically and statistically meaningful results."