The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale

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Messier, Stephen P.; Legault, Claudine; Mihalko, Shannon L.; Miller, Gary D.; Loeser, Richard F.; DeVita, Paul; Lyles, Mary F.; Eckstein, Felix; Hunter, David J.; Williamson, Jeff D.; Nicklas, Barbara J.
Abstract
Background: Obesity is the most modifiable risk factor, and dietary induced weight loss potentially the best nonpharmacologic intervention to prevent or to slow osteoarthritis (OA) disease progression. We are currently conducting a study to test the hypothesis that intensive weight loss will reduce inflammation and joint loads sufficiently to alter disease progression, either with or without exercise. This article describes the intervention, the empirical evidence to support it, and test-retest reliability data. Methods/Design: This is a prospective, single-blind, randomized controlled trial. The study population consists of 450 overweight and obese (BMI = 27-40.5 kg/m2) older (age greater than or equal to 55 yrs) adults with tibiofemoral osteoarthritis. Participants are randomized to one of three 18-month interventions: intensive dietary restriction-plus-exercise; exercise-only; or intensive dietary restriction-only. The primary aims are to compare the effects of these interventions on inflammatory biomarkers and knee joint loads. Secondary aims will examine the effects of these interventions on function, pain, and mobility; the dose response to weight loss on disease progression; if inflammatory biomarkers and knee joint loads are mediators of the interventions; and the association between quadriceps strength and disease progression. Results: Test-retest reliability results indicated that the ICCs for knee joint load variables were excellent, ranging from 0.86 - 0.98. Knee flexion/extension moments were most affected by BMI, with lower reliability with the highest tertile of BMI. The reliability of the semi-quantitative scoring of the knee joint using MRI exceeded previously reported results, ranging from a low of 0.66 for synovitis to a high of 0.99 for bone marrow lesion size. Discussion: The IDEA trial has the potential to enhance our understanding of the OA disease process, refine weight loss and exercise recommendations in this prevalent disease, and reduce the burden of disability. Originally published BMC Musculoskeletal Disorders, Vol. 10, No. 93, July 2009
URI
http://hdl.handle.net/10342/3356
Subject
 Osteoarthritis; Obesity; Nonpharmacologic intervention 
Date
2009-07-28
Citation:
APA:
Messier, Stephen P., & Legault, Claudine, & Mihalko, Shannon L., & Miller, Gary D., & Loeser, Richard F., & DeVita, Paul, & Lyles, Mary F., & Eckstein, Felix, & Hunter, David J., & Williamson, Jeff D., & Nicklas, Barbara J.. (July 2009). The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale. BMC Musculoskeletal Disorders, (10:1), p.93-107. Retrieved from http://hdl.handle.net/10342/3356

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MLA:
Messier, Stephen P., and Legault, Claudine, and Mihalko, Shannon L., and Miller, Gary D., and Loeser, Richard F., and DeVita, Paul, and Lyles, Mary F., and Eckstein, Felix, and Hunter, David J., and Williamson, Jeff D., and Nicklas, Barbara J.. "The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale". BMC Musculoskeletal Disorders. 10:1. (93-107.), July 2009. February 19, 2020. http://hdl.handle.net/10342/3356.
Chicago:
Messier, Stephen P. and Legault, Claudine and Mihalko, Shannon L. and Miller, Gary D. and Loeser, Richard F. and DeVita, Paul and Lyles, Mary F. and Eckstein, Felix and Hunter, David J. and Williamson, Jeff D. and Nicklas, Barbara J., "The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale," BMC Musculoskeletal Disorders 10, no. 1 (July 2009), http://hdl.handle.net/10342/3356 (accessed February 19, 2020).
AMA:
Messier, Stephen P., Legault, Claudine, Mihalko, Shannon L., Miller, Gary D., Loeser, Richard F., DeVita, Paul, Lyles, Mary F., Eckstein, Felix, Hunter, David J., Williamson, Jeff D., Nicklas, Barbara J.. The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale. BMC Musculoskeletal Disorders. July 2009; 10(1) 93-107. http://hdl.handle.net/10342/3356. Accessed February 19, 2020.
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East Carolina University