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    Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial

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    Author
    Messier, Stephen P.; Callahan, Leigh F.; Beavers, Daniel P.; Queen, Kate; Mihalko, Shannon L.; Miller, Gary D.; Losina, Elena; Katz, Jeffrey N.; Loeser, Richard F.; Quandt, Sara A.; DeVita, Paul; Hunter, David J.; Lyles, Mary F.; Newman, Jovita; Hackney, Betsy; Jordan, Joanne M.
    Abstract
    Background: Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. Methods/Design: This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m2) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Discussion: Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA.
    URI
    http://hdl.handle.net/10342/8447
    Date
    2017-02-22
    Citation:
    APA:
    Messier, Stephen P., & Callahan, Leigh F., & Beavers, Daniel P., & Queen, Kate, & Mihalko, Shannon L., & Miller, Gary D., & Losina, Elena, & Katz, Jeffrey N., & Loeser, Richard F., & Quandt, Sara A., & DeVita, Paul, & Hunter, David J., & Lyles, Mary F., & Newman, Jovita, & Hackney, Betsy, & Jordan, Joanne M.. (February 2017). Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial. BMC Musculoskeletal Disorders, (18:1), p.. Retrieved from http://hdl.handle.net/10342/8447

    Display/Hide MLA, Chicago and APA citation formats.

    MLA:
    Messier, Stephen P., and Callahan, Leigh F., and Beavers, Daniel P., and Queen, Kate, and Mihalko, Shannon L., and Miller, Gary D., and Losina, Elena, and Katz, Jeffrey N., and Loeser, Richard F., and Quandt, Sara A., and DeVita, Paul, and Hunter, David J., and Lyles, Mary F., and Newman, Jovita, and Hackney, Betsy, and Jordan, Joanne M.. "Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial". BMC Musculoskeletal Disorders. 18:1. (.), February 2017. August 08, 2022. http://hdl.handle.net/10342/8447.
    Chicago:
    Messier, Stephen P. and Callahan, Leigh F. and Beavers, Daniel P. and Queen, Kate and Mihalko, Shannon L. and Miller, Gary D. and Losina, Elena and Katz, Jeffrey N. and Loeser, Richard F. and Quandt, Sara A. and DeVita, Paul and Hunter, David J. and Lyles, Mary F. and Newman, Jovita and Hackney, Betsy and Jordan, Joanne M., "Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial," BMC Musculoskeletal Disorders 18, no. 1 (February 2017), http://hdl.handle.net/10342/8447 (accessed August 08, 2022).
    AMA:
    Messier, Stephen P., Callahan, Leigh F., Beavers, Daniel P., Queen, Kate, Mihalko, Shannon L., Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., Quandt, Sara A., DeVita, Paul, Hunter, David J., Lyles, Mary F., Newman, Jovita, Hackney, Betsy, Jordan, Joanne M.. Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial. BMC Musculoskeletal Disorders. February 2017; 18(1) . http://hdl.handle.net/10342/8447. Accessed August 08, 2022.
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