Telehealth-delivered diet and exercise program eased knee pain and triggered weight loss

New research investigating the benefits of telehealth-delivered exercise and diet programs has found 80 per cent of participants experienced improvement in knee pain and an average of 10 per cent in loss of body weight, with one man shedding 39 kilograms.

Lito Vilisoni Wilson, University of Melbourne November 29, 2021

More than 400 individuals with knee osteoarthritis participated in the Better Knee, Better Me trial, developed by the University of Melbourne in partnership with Medibank and Austin Health.

Published in the Annals of Internal Medicine today, the study shows researchers evaluated two six-month telehealth-delivered exercise programs, one with and one without a weight-loss dietary program, compared with an information-only control group.

During the trial, participants in the intervention groups were provided support from physiotherapists and dietitians via Zoom and a suite of resources. Those in the exercise plus diet group also received meal replacements so they could undertake a ketogenic low energy diet.

Compared to the group that only received information, both intervention programs resulted in benefits for pain, function and quality of life. Compared to the exercise-only program, the combined exercise and diet program led to additional benefits – including a greater reduction in pain, greater improvements in physical function, lower use of pain medications, and significant weight loss. After both programs, participants were also less willing to undergo knee joint replacement surgery.

Lead researcher and Director of the Centre for Health, Exercise and Sports Medicine at the University of Melbourne Professor Kim Bennell, said participants lost on average 10.2 kilograms over a six-month period with four out of five participants achieving significant improvement in pain. She said 30 per cent of participants lived in regional and rural Australia.

“We are proud to have developed a program that has a strong regional and rural representation and is based on a trial which made a real difference in the lives of participants. Particularly during these times of pandemic-related travel restrictions, it is crucial Australians are able to access home-based treatments to manage their osteoarthritis symptoms, no matter where they live or what COVID restrictions are in place.”

Participant Matthew Boyd, from Toowoomba in Queensland, said his knee pain had become unbearable and was struggling to do the things he enjoyed, leading to a decline in physical activity and an increase in his weight.

“Since taking part in Better Knee, Better Me™, I feel amazing. I have lost 16kgs which has decreased the weight load on my knees, and my pain. I no longer take any pain relief for my knee pain, which has meant I have been able to return to all the physical activities I wasn’t able to do over the past five years. The pain in my knees no longer dictates my daily routine and I am back moving in a way I haven’t done in years,” Mr Boyd said.

Around 2.1 million Australians are currently living with osteoarthritis. The prevalence of osteoarthritis is expected to increase by 58 per cent by 2032 due to an ageing population and rising obesity rates.

Medibank Head of Member Health Service and Design Catherine Keating said Medibank wants to provide its customers with healthcare that gives them more choice and control in how they receive their care.

“It’s part of our focus on taking the lead on driving preventative health because we know our customers want personalised support to improve their health and wellbeing.”

Source University of Melbourne via Science Daily

References

Comparing Video-Based, Telehealth-Delivered Exercise and Weight Loss Programs With Online Education on Outcomes of Knee Osteoarthritis: A Randomized Trial, Bennell KL, Lawford BJ, Keating C, Brown C, Kasza J, Mackenzie D, Metcalf B, Kimp AJ, Egerton T, Spiers L, Proietto J, Sumithran P, Harris A, Quicke JG, Hinman RS. Ann Intern Med. 2021 Nov 30. doi: 10.7326/M21-2388. Epub ahead of print.

Further reading

Does telephone-delivered exercise advice and support by physiotherapists improve pain and/or function in people with knee osteoarthritis? Telecare randomised controlled trial, Hinman RS, Campbell PK, Lawford BJ, Briggs AM, Gale J, Bills C, Kasza J, Harris A, French SD, Bunker SJ, Forbes A, Bennell KL. Br J Sports Med. 2020 Jul;54(13):790-797. doi: 10.1136/bjsports-2019-101183. Epub 2019 Nov 20.

Better Knee, Better Me™: effectiveness of two scalable health care interventions supporting self-management for knee osteoarthritis – protocol for a randomized controlled trial, Bennell KL, Keating C, Lawford BJ, Kimp AJ, Egerton T, Brown C, Kasza J, Spiers L, Proietto J, Sumithran P, Quicke JG, Hinman RS; Better Knee, Better Me™ study team, Harris A, Briggs AM, Page C, Choong PF, Dowsey MM, Keefe F, Rini C. BMC Musculoskelet Disord. 2020 Mar 12;21(1):160. doi: 10.1186/s12891-020-3166-z. Full text

Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain: A Randomized Trial, Bennell KL, Nelligan R, Dobson F, Rini C, Keefe F, Kasza J, French S, Bryant C, Dalwood A, Abbott JH, Hinman RS. Ann Intern Med. 2017 Apr 4;166(7):453-462. doi: 10.7326/M16-1714. Epub 2017 Feb 21.

Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: a randomised controlled trial protocol, Bennell KL, Egerton T, Bills C, Gale J, Kolt GS, Bunker SJ, Hunter DJ, Brand CA, Forbes A, Harris A, Hinman RS. BMC Musculoskelet Disord. 2012 Dec 11;13:246. doi: 10.1186/1471-2474-13-246. Full text

Also see
Weight loss and exercise helping to manage osteoarthritis Medibank
Study: Low-carb diet provides relief from knee osteoarthritis University of Alabama at Birmingham