Lifestyle intervention effects on overweight adults with knee osteoarthritis

Abstract

Osteoarthritis (OA) is a prevalent musculoskeletal condition affecting adults worldwide. This degenerative process leads to pain, stiffness, swelling, impaired joint function, reduced quality of life, and psychological impacts. The tibiofemoral joint is commonly affected in OA cases, with an imbalance of load across the medial and lateral compartments during walking being a key risk factor for OA progression. Estimating the load on the medial side during walking is crucial for managing medial knee OA. Research has explored lifestyle interventions that might correct this load imbalance, showing promising outcomes. The main objectives of this thesis were twofold: first, to review clinical trials targeting knee adduction moment (KAM) as a measure for knee OA, and second, to conduct a randomized controlled trial on lifestyle interventions aimed at mitigating OA progression risk factors. These interventions were hypothesized to reduce symptoms like pain and physical dysfunction by modifying knee joint biomechanical forces. This thesis comprises six chapters employing various scientific methodologies, including a systematic review, the design of a novel randomized controlled trial, reliability analysis, and linear mixed model analysis in a knee OA cohort. Together, these studies analyse the relationship between biomechanical factors, lifestyle interventions (such as resistance training, caloric restriction, and gait retraining), and clinical outcomes like pain and physical function. The overarching goal is to provide a more holistic, evidence-based, patient-centred approach for managing knee OA. The thesis highlights the importance of rigorous protocols, quality control, and continued education for exercise scientists and biomechanists, as well as the potential for lifestyle interventions to support health care professionals in enhancing care for older adults with OA who suffer from pain and disability.