Abstract

NICE guidance stipulates exercise and weight loss as ‘Core’ treatments for Osteoarthritis (OA). Typically, NHS physiotherapists and dieticians deliver these treatments within the secondary health care setting. Given increasing demands placed upon secondary health care professionals, we conducted a novel, community based, registered exercise professional led, exercise and dietary intervention in obese patients with established knee OA, to evaluate its efficacy and potentially widespread use within the National Exercise Referral Scheme in Wales. 81 patients (BMI<30) with knee OA were invited (mean age 57 y, BMI 39.5 kg/m²) from Orthopaedic, Rheumatology and Primary care settings. 58 patients declined to take part. 1 patient was excluded at assessment due to medical concerns. The pilot was a 16 week dietary and exercise programme delivered in the community setting. Patients performed 2 x1 hour per week of a 10-station exercise carousel incorporating aerobic and resistance exercise aimed at quadriceps and hamstring strengthening. 1 hour per week of dietary education was given, using Public Health Wales’ ‘Foodwise for Life’ programme, and 3 sessions of practical cooking skills over 16 weeks. Primary outcome measures were the Oxford Knee Score (OKS); Quality of Life (QoL) (EQ-5D+EQ-VAS); physical function (6 minute walk test (6MWT) and 30 second sit-stand (30 s s-s)). Secondary measures; body weight; resting Blood Pressure(BP); resting heart rate (RHR). 18 patients completed the 16 week programme. Improvements were seen in OKS (p=0.048), 6MWT (p<0.001), 30 s s-s (p<0.001), EQ-VAS (p=0.01), weight (p=0.001) and systolic BP (p<0.001). No significant improvements were seen in diastolic BP (p=0.96), RHR (p=0.11) and EQ-5D (p=0.11). This pilot suggests a community based, exercise professional led intervention for patients with knee OA as a clinically effective therapeutic resource for health professionals.