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

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• 作者：Stephen P Messier (1)
  Claudine Legault (2)
  Shannon Mihalko (1)
  Gary D Miller (1)
  Richard F Loeser (3)
  Paul DeVita (4)
  Mary Lyles (5)
  Felix Eckstein (6) (8)
  David J Hunter (7)
  Jeff D Williamson (5)
  Barbara J Nicklas (5)
  
• 刊名：BMC Musculoskeletal Disorders
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：10
• 期：1
• 全文大小：1717KB
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  52. The pre-publication history for this paper can be accessed here:dcentral.com/1471-2474/10/93/prepub" class="a-plus-plus">http://www.biomedcentral.com/1471-2474/10/93/prepub
  
• 作者单位：Stephen P Messier (1)
  Claudine Legault (2)
  Shannon Mihalko (1)
  Gary D Miller (1)
  Richard F Loeser (3)
  Paul DeVita (4)
  Mary Lyles (5)
  Felix Eckstein (6) (8)
  David J Hunter (7)
  Jeff D Williamson (5)
  Barbara J Nicklas (5)
  
  1. Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
  2. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
  3. Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
  4. Department of Exercise and Sport Science, East Carolina University, Greenville, NC, USA
  5. Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, USA
  6. Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria
  8. Chondrometrics GmbH, Ainring, Germany
  7. Division of Research, New England Baptist Hospital, Boston, MA, USA
  

文摘

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 = 27-0.5 kg/m2) older (age ?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. Trial Registration NCT00381290