Telehealth Diet and Exercise Benefits Knee Osteoarthritis Save

Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight.  While both were beneficial, exercise had a greater effect than dietary instruction delivered by telehealth.

This Australian study assessed if a telehealth-delivered exercise program would be further enhanced by also providing a dietary intervention.

They enrolled 415 patients with painful knee osteoarthritis and a body mass index between 28 and 40 kg/m2 who were aged 45 to 80 years.  The primary endpoint was the WOMAC pain scale. These unblinded interventions included:

• An exercise program with 6 physiotherapist consultations via videoconference for exercise, self-management advice, and behavioral counseling (all patients).
• A diet program included an 6 dietitian consultations for a ketogenic very-low-calorie diet (2 formulated meal replacements and a low-carbohydrate meal daily) followed by a transition to healthy eating (half the patients).

Six month outcomes were available on 379 (91%) and 372 (90%) provided 12-month primary outcomes. At 6 months, both programs (exercise vs excercise plus diet) showed significant improvement in pain control and function. The diet and exercise program was modestly superior to exercise alone intervention with (pain, −0.6 [CI, −1.1 to −0.2]; function, −2.8 [CI, −4.7 to −0.8]). Findings were similar at 12 months.

Thus, significant gains can be achieved via telehealth in symptomatic, obese knee osteoarthritis. Supervised instruction on exercise and diet are cost effective interventions to be delivered by telemedicine.