Weight Loss And Mobility Performance In Obese Knee Osteoarthritis Patients: Evidence From The CLIP-OA Trial

Being overweight or obese is a primary modifiable risk factor that exacerbates functional decline in older knee osteoarthritis (OA) patients. Unfortunately, community access to practical, sustainable weight management interventions remains limited and places knee OA patients at increased risk of mobility disability. PURPOSE: The Collaborative Lifestyle Intervention Program in Knee Osteoarthritis patients (CLIP-OA), was a two-arm, 18-month randomized-controlled, comparative effectiveness trial designed to contrast the effects of an evidence-based, weight loss intervention (EX+DWL) with those of the Arthritis Foundation’s Walk With Ease (WWE) standard of care self-management program, delivered by our community partners, in the treatment of older, knee OA patients who are overweight or obese. In the current study, we evaluated the intervention effects on mobility performance (400MWT) and weight loss at the end of the 6-month intensive phase of the trial. METHODS: A total of 227 knee OA patients (M age = 65 years) were randomly assigned to the EX+DWL (n = 111) or WWE (n = 116) interventions. Mobility performance and weight loss assessments were obtained at baseline and 6-month follow-up. RESULTS: Intention to treat analysis of baseline-adjusted change scores yielded a non-significant Treatment effect for mobility performance (p > 0.47) and a significant Treatment effect for weight loss (p < 0.01) at 6 months. Results revealed comparable improvements in 400MWT with the EX+DWL (∆ = -23.31 seconds) and WWE interventions (∆ = -14.70 seconds). Conversely, EX+DWL resulted in significantly greater weight loss (∆ = -9.72 lbs) relative to WWE (∆ = -2.20 lbs) at 6 months. CONCLUSIONS: Findings suggest that while comparable improvements in mobility performance were observed following each intervention, the EX+DWL intervention resulted in superior weight loss when compared to WWE following the 6-month intensive phase of the trial. These results reinforce the efficacy of lifestyle behavior change and weight loss for preserving mobility performance among older knee OA patients. Additionally, the CLIP-OA findings underscore the promise of offering a sustainable medium for intervention delivery that can promote widely accessible programming to knee OA patients in need of weight management.