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Obese and non-obese patients with osteoarthritis: a comparison of functioning and outcome.

Veenhof, C., Dekker, J. Obese and non-obese patients with osteoarthritis: a comparison of functioning and outcome. European Journal of Public Health: 2009, 19(suppl. 1), p. 149. Abstract. 17th European Public Health Conference 'Human Ecology and Public Health', 25–28 November 2009, Lodz (Polen).
Background: The prevalence of obesity among patients with osteoarthritis is high. To find the optimal treatment it is interesting to study in which aspects obese patients with osteoarthritis differ from non-obese patients. The objective of this study was to examine the influence of obesity on (i) functioning of patients with osteoarthritis of the hip or knee and (ii) on the effectiveness of behavioral graded activity. Methods: A cluster randomized controlled trial on the effectiveness of Behavioral Graded Activity, compared with exercise therapy according to the Dutch physiotherapy guideline, was performed. This trial involved 200 patients with hip and/or knee osteoarthritis (ACR-criteria). To compare functioning of obese (BMI >30) and non-obese patients at baseline, data on pain (VAS), fatigue (VAS) and physical function (WOMAC, walking time test) were collected and compared using Chisquare and t-tests. To analyse the differences in effectiveness of Behavioral Graded Activity, between obese and non-obese patients, multiple regression analysis was performed. Primary outcome measures were pain (VAS), physical function (WOMAC), and patient global assessment. Results: At baseline, obese patients with osteoarthritis reported significantly more pain, fatigue, and a lower level of physical function, compared with non-obese patients. Also, obese patients performed significantly less on the walking test compared with non-obese patients. Concerning the effectiveness of Behavioral Graded Activity, it was found that, after 65 weeks, physical function of patients with obesity improved significantly more compared with non-obese patients. No differences were found on the outcome measures pain and patient global assessment. Conclusions: In patients with osteoarthritis, obesity is an important factor, which negatively influences functioning. Furthermore, it seems that Behavioral Graded Activity has a better outcome, compared with exercise therapy, for obese patients with osteoarthritis.