Rejeski, W. J. et al. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol. 21, 419-426

Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA.
Health Psychology (Impact Factor: 3.59). 10/2002; 21(5):419-26. DOI: 10.1037//0278-6133.21.5.419
Source: PubMed


This study examined the effects of dietary weight loss and exercise on the health-related quality of life (HRQL) of overweight and obese, older adults with knee osteoarthritis. A total of 316 older men and women with documented evidence of knee osteoarthritis were randomly assigned to 1 of 4 18-month interventions: dietary weight loss, exercise, dietary weight loss and exercise, or healthy lifestyle control. Measures included the SF-36 Health Survey and satisfaction with body function and appearance. Results revealed that the combined diet and exercise intervention had the most consistent, positive effect on HRQL compared with the control group; however, findings were restricted to measures of physical health or psychological outcomes that are related to the physical self.

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    • "Radiographic/tibiofemoral/antero-posterior/KL severity No within physical activity group change over time Durmus et al., 2012 MRI/tibiofemoral/cartilage volume Some MRI parameter improvements within physical activity group over time Ettinger et al., 1997þ Radiographic/tibiofemoral/antero-posterior and lateral/OA severity No between group difference post intervention Mikesky et al., 2006 Radiographic/tibiofemoral/antero-posterior/joint space width, joint space narrowing and osteophytosis severity Both physical activity groups showed non-significant trends towards joint space width narrowing over time Kawasaki et al., 2008 Radiographic/tibiofemoral/anteroposterior/joint space width No between group difference post intervention Rejeski et al., 2002þ Radiographic/tibiofemoral and patellofemoral/anteroposterior and sunrise/joint space width and KL No between group difference post intervention No within physical activity group change over time Key: þ ¼ results were taken from the primary trial paper and additional follow up papers pertaining to the same trial. Abbreviations: MRI ¼ magnetic resonance imaging; KL¼ Kellgren and Lawrence OA grading. "
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    ABSTRACT: To determine whether long-term physical activity is safe for older adults with knee pain. A comprehensive systematic review and narrative synthesis of existing literature was conducted using multiple electronic databases from inception until May 2013. Two reviewers independently screened, checked data extraction and carried out quality assessment. Inclusion criteria for study designs were randomised controlled trials (RCTs), prospective cohort studies or case control studies, which included adults of mean age over 45 years old with knee pain or osteoarthritis (OA), undertaking physical activity over at least three months and which measured a safety related outcome (adverse events, pain, physical functioning, structural OA imaging progression or progression to total knee replacement (TKR)). Of the 8614 unique references identified, 49 studies were included in the review, comprising 48 RCTs and one case control study. RCTs varied in quality and included an array of low impact therapeutic exercise interventions of varying cardiovascular intensity. There was no evidence of serious adverse events, increases in pain, decreases in physical function, progression of structural OA on imaging or increased TKR at group level. The case control study concluded that increasing levels of regular physical activity was associated with lower risk of progression to TKR. Long-term therapeutic exercise lasting three to thirty months is safe for most older adults with knee pain. This evidence supports current clinical guideline recommendations. However, most studies investigated selected, consenting older adults carrying out low impact therapeutic exercise which may affect result generalizability. PROSPERO 2014:CRD42014006913. Copyright © 2015. Published by Elsevier Ltd.
    Osteoarthritis and Cartilage 05/2015; 60(9). DOI:10.1016/j.joca.2015.05.002 · 4.17 Impact Factor
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    • "There is a consistent association of higher HRQL scores with higher levels of physical activity among healthy adults in cross-sectional studies [34], and this association is stronger on the physical dimension of the HRQL than the mental dimension [34]. We also know that interventions combining physical activity and diet improve the physical dimension of HRQL but not the mental dimension among older obese individuals with knee ostoearthritis [35]. "
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    ABSTRACT: There is little robust evidence relating to changes in health related quality of life (HRQL) in morbidly obese patients following a multidisciplinary non-surgical weight loss program or laparoscopic Roux-en-Y Gastric Bypass (RYGB). The aim of the present study was to describe and compare changes in five dimensions of HRQL in morbidly obese subjects. In addition, we wanted to assess the clinical relevance of the changes in HRQL between and within these two groups after one year. We hypothesized that RYGB would be associated with larger improvements in HRQL than a part residential intensive lifestyle-intervention program (ILI) with morbidly obese subjects. A total of 139 morbidly obese patients chose treatment with RYGB (n=76) or ILI (n=63). The ILI comprised four stays (seven weeks) at a specialized rehabilitation center over one year. The daily schedule was divided between physical activity, psychosocially-oriented interventions, and motivational approaches. No special diet or weight-loss drugs were prescribed. The participants completed three HRQL-questionnaires before treatment and 1 year thereafter. Both linear regression and ANCOVA were used to analyze differences between weight loss and treatment for five dimensions of HRQL (physical, mental, emotional, symptoms and symptom distress) controlling for baseline HRQL, age, age of onset of obesity, BMI, and physical activity. Clinical relevance was assessed by effect size (ES) where ES<.49 was considered small, between .50-.79 as moderate, and ES>.80 as large. The adjusted between group mean difference (95% CI) was 8.6 (4.6,12.6) points (ES=.83) for the physical dimension, 5.4 (1.5–9.3) points (ES=.50) for the mental dimension, 25.2 (15.0–35.4) points (ES=1.06) for the emotional dimension, 8.7 (1.8–15.4) points (ES=.37) for the measured symptom distress, and 2.5 for (.6,4.5) fewer symptoms (ES=.56), all in favor of RYGB. Within-group changes in HRQOL in the RYGB group were large for all dimensions of HRQL. Within the ILI group, changes in the emotional dimension, symptom reduction and symptom distress were moderate. Linear regression analyses of weight loss on HRQL change showed a standardized beta-coefficient of –.430 (p<.001) on the physical dimension, –.288 (p=.004) on the mental dimension, –.432 (p<.001) on the emotional dimension, .287 (p=.008) on number of symptoms, and .274 (p=.009) on reduction of symptom pressure. Morbidly obese participants undergoing RYGB and ILI had improved HRQL after 1 year. The weaker response of ILI on HRQL, compared to RYGB, may be explained by the difference in weight loss following the two treatments. Trial registration Clinical number NCT00273104
    Health and Quality of Life Outcomes 02/2013; 11(1):17. DOI:10.1186/1477-7525-11-17 · 2.12 Impact Factor
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    • "The level of physical activity - as one of the elements of functional fitness - plays a significant role here. It allows for the prevention and modification of many negative factors affecting the process of aging (King et al., 2000; Rejeski et al., 2002). "
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    ABSTRACT: The purpose of the study was to assess factors determining physical activity in persons at the age of 60-69 years in an urban area. The study included 262 working residents of Warsaw at the initial period of old age. The study utilized a questionnaire consisting of two parts. The first part concerned recreational and touristic activities in the previous year. The second is a Polish version of IPAQ, assessing the respondents' level of activity throughout the past week. Based on IPAQ results, the respondents were divided into physically active and inactive ones. The active group included people meeting moderate to vigorous physical activity, whereas the inactive group included people who took up no physical activity at all or those with a low physical activity level. The relations between taking up physical activity and the variables characterizing the demographic structure as well as touristic and recreational activity of the respondents were assessed with the use of a log-linear analysis. Out of the variables taken into account, age, education and participation in physical recreation proved to be significant factors in taking up activity by the elderly. The odds ratios computed for the analyzed variables indicate that the risk of being inactive increases over two times after exceeding 65 years of age; a risk of similar magnitude was also observed in case of less educated populations. Regular participation in physical recreation provides a four-times increase in the chances to achieve levels of physical activity sufficient to remain healthy.
    Journal of Human Kinetics 12/2011; 30(1). DOI:10.2478/v10078-011-0085-y · 1.03 Impact Factor
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