The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity

Huang, Mao-Hsiung; Chen, Chia-Hsin; Chen, Tien-Wen; Weng, Ming-Cheng; Wang, Wen-Ta; Wang, Yulin

doi:10.1002/1529-0131(200012)13:6<398::aid-art10>3.0.co;2-e

Cited by 92 publications

(82 citation statements)

References 20 publications

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“…Weight loss appears to positively affect pain outcomes both in terms of lowering the risk of developing problems, such as musculoskeletal pain and OA, and reducing pain-related distress and disability [87][88]. A variety of different weight-reduction treatment approaches has been evaluated.…”

Section: Effect Of Treatment On Pain and Weight Outcomesmentioning

confidence: 99%

“…Huang and colleagues examined the effects of weight reduction and electrotherapy on pain relief and functional improvement in 126 obese patients with knee OA [88]. Participants were divided into one of three treatment groups: weight reduction, weight reduction and electrotherapy (i.e., transcutaneous electric stimulation for pain relief), or electrotherapy alone.…”

Section: Lifestyle Intervention/behavioral Weight-loss Treatmentmentioning

confidence: 99%

“…Weight reduction of 15 percent of initial body weight resulted in clinically and statistically significant pain relief, whereas a 12 percent weight reduction resulted in acceptable functional status. The researchers concluded that incorporation of electrotherapy for pain control, when appropriate, may be an important adjunct to weight-management treatment [88].…”

Section: Lifestyle Intervention/behavioral Weight-loss Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

Janke¹,

Collins²,

Kozak³

2007

JRRD

187

141

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Abstract-Overweight/obesity and pain are significant problems of increasing prevalence; understanding the relationship between the two is the focus of a growing body of research. Findings from this review support a likely relationship between increasing weight and pain conditions such as osteoarthritis and low back pain. Longitudinal studies suggest overweight/obesity early in life is a risk factor for pain, and the co-occurrence of pain and overweight/obesity negatively affects quality of life. The mechanism of relationship is unknown but is hypothesized to include mechanical and metabolic abnormalities, possibly secondary to lifestyle choices. Observations from a few studies demonstrate that treatments for obesity reduce pain secondary to weight loss. Few studies examine both pain and weight as primary outcomes, and variability in measurement makes comparisons and conclusions difficult. Research should focus on expanding knowledge about mechanisms of the relationship between pain and obesity, testing explanatory models addressing their co-occurrence, and developing treatments that most effectively target this comorbidity.

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Section: Effect Of Treatment On Pain and Weight Outcomesmentioning

confidence: 99%

Section: Lifestyle Intervention/behavioral Weight-loss Treatmentmentioning

confidence: 99%

Section: Lifestyle Intervention/behavioral Weight-loss Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

Janke¹,

Collins²,

Kozak³

2007

JRRD

187

141

View full text Add to dashboard Cite

show abstract

“…12 It also reduces the symptoms and/or improves the clinical findings in several obesity-related chronic conditions, such as diabetes, 12 coronary heart disease, 13 asthma, 14,15 obstructive sleep apnoea, [16][17][18] and osteoarthrosis. 19,20 The marked weight loss achieved by surgical techniques has been associated with clear long-term improvements in HRQL. [21][22][23][24][25][26][27] The previous weight loss studies with lifestyle intervention have shown various improvements in HRQL, but the studies have usually been very short in duration.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification—a 2-y follow-up study

et al. 2003

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OBJECTIVE:To study health-related quality of life (HRQL) in a clinically selected sample of obese outpatients. DESIGN: A single-strand before and after study with 2-y follow-up after treatment comprising 10 weeks on very-low-energy diet (VLED) and 4 months of behaviour modification in groups. SUBJECTS: A total of 126 (mean (s.d.) age 48.2 (11.1) y and body mass index 42.8 (6.2) kg/m 2 obese patients (63% women) referred for treatment in an obesity clinic. MEASUREMENTS: Weight and HRQL using questionnaires (RAND 36-Item Health Survey 1.0 and Obesity-related Psychosocial problems scale (OP-scale)). RESULTS: A total of 100 patients (61% women) completed the treatment and 67 (71% women) completed the 2-y follow-up. The mean (s.d.) weight loss was 12.5 (5.6)% at the end of group therapy, 6.0 (7.1)% at 1 y, and 2.6 (7.5)% at 2 y. At baseline, the mean (s.d.) score for the OP-scale was 61.9 (24.6). The mean scores on every RAND-36 scale were markedly lower than in the Finns without chronic conditions. All the scales in HRQL improved markedly during the treatment. During the follow-up, all the scales started to return towards baseline levels, and at 2 y only obesity-related psychosocial problems and physical functioning were still improved relative to baseline. In categories of weight change at 2 y (Z10% weight loss, 0-9.9% weight loss, weight gain), obesity-related psychosocial functioning, physical functioning, and general health showed dose-response improvement with increasing weight loss. A Z10% weight loss at 2 y after treatment was associated with clear improvement in obesity-related psychosocial problems, physical functioning, physical role functioning, bodily pain, general health, mental health, and vitality. A 0-9.9% weight loss was associated with improvement in obesity-related psychosocial problems and physical functioning. Weight gain was associated with improvement in obesity-related psychosocial problems and social functioning. The study population was too small to examine possible gender differences. CONCLUSIONS: Treatment with VLED and behaviour modification produces marked short-term weight loss and clear improvement in all aspects of HRQL. At 2 y after treatment, the average maintained weight loss is modest. However, 1/3 of patients maintained a Z5% weight loss. Improvement in obesity-related psychosocial problems and physical functioning is associated even with less than 10% of maintained weight loss. Since the pattern of HRQL changes only partly followed the pattern of weight change as expected, other factors, such as the therapeutic effect of participating in the weight loss programme or increase in physical activity, may affect HRQL responses.

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“…However, several modifiable factors were identified that were independently linked to function outcome after adjusting for pain intensity, which supports a multifaceted approach. Results of short-term studies have suggested the greater benefit of combined approaches (e.g., acupuncture/diet/exercise versus pain therapy alone [49]). Moreover, the effect sizes for strengthening interventions appear to be enlarged by incorporating pain management, attention to psychosocial factors, self-management, or aerobic exercise into the intervention (50,51).…”

mentioning

confidence: 99%

Physical functioning over three years in knee osteoarthritis: Role of psychosocial, local mechanical, and neuromuscular factors

Sharma

Cahue

Song

et al. 2003

Arthritis & Rheumatism

417

351

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Objective. To identify factors that predict a poor physical function outcome over 3 years in individuals with knee osteoarthritis (OA), in an effort to aid in the development of strategies to prevent such functional limitations and consequential disability.Methods. Community-recruited individuals with knee OA underwent baseline, 18-month, and 3-year assessments of candidate risk factors and physical function. Risk factors were age, body mass index (BMI), knee pain intensity (on a visual analog scale [VAS]), local mechanical and neuromuscular factors (varusvalgus laxity, malalignment, proprioceptive inaccuracy, quadriceps strength, hamstring strength), activity level (Physical Activity Scale for the Elderly, amount of aerobic exercise), and psychosocial factors (Short-Form 36 [SF-36] mental health and role-functioning emotional subscales, self-efficacy using the Arthritis SelfEfficacy Scale physical function subscale, and social support using the Medical Outcomes Study Social Support Survey). Outcome was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scale and rate of chair-stand performance. Participants were grouped by quintile of baseline WOMAC score. The baseline to 3-year outcome was considered "good" when function improved by 1 or more quintiles or remained within the 2 highest function groups, and was considered "poor" when function declined by 1 or more quintiles or remained within the 3 lowest function groups. The same approach was taken for chair-stand outcome. Logistic regression was used to evaluate both the baseline level and the baseline to 18-month change in each factor as a predictor of physical function outcome over 3 years, adjusting for age, BMI, knee pain intensity, disease severity, and additional potential confounders. Results. Factors that significantly increased the likelihood of a poor WOMAC outcome were baseline laxity (crude odds ratio

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The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity

Cited by 92 publications

References 20 publications

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

Overview of the relationship between pain and obesity: What do we know? Where do we go next?

Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification—a 2-y follow-up study

Physical functioning over three years in knee osteoarthritis: Role of psychosocial, local mechanical, and neuromuscular factors

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