Christine A Pellegrini1, Rowland W Chang2, Dorothy D Dunlop3, David E Conroy4, Jungwha Lee2, Linda Van Horn2, Bonnie Spring2, Kenzie A Cameron5. 1. University of South Carolina, Department of Exercise Science, Technology Center to Promote Health Lifestyles, 915 Greene Street, Suite 403, Columbia, SC 29208, United States; Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, United States. Electronic address: cpellegrini@sc.edu. 2. Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, United States. 3. Northwestern University, Feinberg School of Medicine, Institute for Public Health and Medicine, Center for Healthcare Studies, 633 N. St. Clair, Chicago, IL 60611, United States. 4. The Pennsylvania State University, Department of Kinesiology, 268U Recreation Building, University Park, PA 16802, United States. 5. Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, United States; Northwestern University, Feinberg School of Medicine, Division of Internal Medicine and Geriatrics, Department of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611, United States.
Abstract
BACKGROUND: Most patients risk gaining weight in the years after knee replacement, adding further concern to a population that is mostly overweight/obese prior to surgery. OBJECTIVE: Via a randomised pilot study, we assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement, while simultaneously examining the feasibility of recruiting and retaining participants over 26 weeks. METHODS: Recruitment outreach was made to 133 patients scheduled for knee replacement. Sixteen participants were randomised to a 14-session weight loss program that started either ≤6 weeks before surgery (PACE) or at 12 weeks post-op (Delayed PACE). Repeated measures ANOVAs were used to examine preliminary changes in weight, function, patient-reported outcomes, and physical activity across time (baseline/pre-op, 12 and 26 weeks after surgery) and group. RESULTS:Retention was 75% and 69% at 12 and 26 weeks after surgery, respectively. Weight significantly decreased across the 26 weeks (P<0.001). A group by time interaction (P=0.03) demonstrated Delayed PACE [-7.6±5.9kg (-7.9±5.9%)] lost significantly more weight than PACE [-2.5±2.7kg (-2.6±2.6%)] participants at 26 weeks. Significant improvements across time were seen for all function and patient reported outcomes, however activity did not change. CONCLUSION: Conducting a behavioural intervention was challenging but feasible in a knee replacement population, with preliminary evidence suggesting that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks compared to a program starting before knee replacement.
RCT Entities:
BACKGROUND: Most patients risk gaining weight in the years after knee replacement, adding further concern to a population that is mostly overweight/obese prior to surgery. OBJECTIVE: Via a randomised pilot study, we assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement, while simultaneously examining the feasibility of recruiting and retaining participants over 26 weeks. METHODS: Recruitment outreach was made to 133 patients scheduled for knee replacement. Sixteen participants were randomised to a 14-session weight loss program that started either ≤6 weeks before surgery (PACE) or at 12 weeks post-op (Delayed PACE). Repeated measures ANOVAs were used to examine preliminary changes in weight, function, patient-reported outcomes, and physical activity across time (baseline/pre-op, 12 and 26 weeks after surgery) and group. RESULTS: Retention was 75% and 69% at 12 and 26 weeks after surgery, respectively. Weight significantly decreased across the 26 weeks (P<0.001). A group by time interaction (P=0.03) demonstrated Delayed PACE [-7.6±5.9kg (-7.9±5.9%)] lost significantly more weight than PACE [-2.5±2.7kg (-2.6±2.6%)] participants at 26 weeks. Significant improvements across time were seen for all function and patient reported outcomes, however activity did not change. CONCLUSION: Conducting a behavioural intervention was challenging but feasible in a knee replacement population, with preliminary evidence suggesting that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks compared to a program starting before knee replacement.
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