Further, the diet and exercise program was superior to exercise alone for pain (- 0.6) and for function (- 2.8).
Findings were similar at 12 months.
Dr. Bennell added, “Both interventions were co-designed with Medibank Private, Australia’s largest provider of private health insurance with over 3.7 million members, to ensure that they could be feasibly implemented beyond the research setting. The interventions were also designed to have a limited number of clinician consultations…to minimize intervention costs and were structured in their content so that they could be replicated.”
Dr. Jeffrey Geller, Chief of Orthopedic Surgery at NewYork Presbyterian Lawrence Hospital in Bronxville, commented on the study in an email to Reuters Health. “The biggest concern I have with this study is the inherent selection bias and outcome bias. The patients all volunteered for the study, which likely leads to a higher rate of compliance with prescribed treatment compared to the general population.”
“In addition,” he said, “there was a relatively high attrition rate, whereby those patients having less success or unwilling to complete the treatment for the full six months dropped out, leading to a likely higher rate of positive outcomes in those patients that completed the six months of treatment.”
“Nonetheless,” he added, “there is value in this study which clearly demonstrated that an active, monitored program where patients who are actively monitored can successfully lose weight, improve their exercise level, improve their mood, and most importantly decrease their pain level.”
“If implemented on a broader scale, (the program) needs to have a mechanism to identify those patients losing motivation, who risk falling out of a potentially beneficial intervention program,” Dr. Geller concluded.
Reference
- Bennell KL, Lawford BJ, Keating C, et al. Comparing video-based, telehealth-delivered exercise and weight loss programs with online education on outcomes of knee osteoarthritis: A randomized trial. Ann Intern Med. 2021 Nov 30. Online ahead of print.
