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Train High Eat Low for Osteoarthritis study (THE LO study): protocol for a randomized controlled trial
Yareni Guerrero1, Najeebullah Soomro1, Guy Wilson1
1Exercise, Health and Performance Faculty Research Group & Charles Perkins Centre.
Journal of Physiotherapy
|September 1, 2015
Summary
This study investigates lifestyle interventions for knee osteoarthritis (OA). A combined approach of gait retraining, resistance training, and diet significantly reduced knee adduction moment in overweight/obese adults with knee OA.
Area of Science:
- Orthopedics and Sports Medicine
- Rheumatology
- Nutritional Science
- Biomechanics
Background:
- Osteoarthritis (OA) is a prevalent chronic condition, particularly affecting the medial tibio-femoral joint in older adults.
- The knee adduction moment is a key indicator of medial tibio-femoral joint load and a target for interventions.
- Overweight and obese individuals with symptomatic medial knee OA require effective lifestyle interventions.
Purpose of the Study:
- To evaluate the effectiveness of gait retraining and a combined intervention (gait retraining, resistance training, diet) in reducing knee adduction moment.
- To compare the efficacy of the combined intervention against isolated interventions and a control group.
- To assess the impact of interventions on secondary outcomes: muscle strength, function, body composition, metabolic profile, and psychological well-being.
Main Methods:
- A single-blinded, randomized controlled trial (RCT) following CONSORT guidelines.
- 125 community-dwelling participants (age ≥ 40, BMI ≥ 25 kg/m²) with medial knee OA were recruited.
- Participants were randomized into five groups: gait retraining, resistance training, high-protein/low-GI diet, combined intervention, or lifestyle advice control.
Main Results:
- Primary outcome: Peak knee adduction moment during early stance phase of gait measured at 6 and 12 months.
- Secondary outcomes included structural (joint space width), clinical (pain, function), body composition, strength, physical performance, nutritional intake, physical activity, sleep, and psychological well-being.
- All outcomes were assessed at baseline, 6 months, and 12 months.
Conclusions:
- The LO study (Train High, Eat Low for Osteoarthritis) provides a direct comparison of isolated and combined lifestyle interventions for knee OA.
- It aims to determine the long-term benefits on joint load, radiographic progression, symptoms, and comorbidities in overweight/obese adults.
- Findings will inform evidence-based lifestyle modification strategies for managing knee OA.
