The effect of a combined programme of dietary restriction and physical activity on the physical function and body composition of obese middle-aged and older adults with knee osteoarthritis

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Alrushud, Asma (2019). The effect of a combined programme of dietary restriction and physical activity on the physical function and body composition of obese middle-aged and older adults with knee osteoarthritis. University of Birmingham. Ph.D.

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Abstract

The work reported in this thesis was driven by the limited existing evidence investigating the effect of a combined intervention programme of dietary restriction and physical activity on overweight/obese older adults with knee osteoarthritis (OA).
This thesis comprises three phases: 1) a systematic literature review to synthesise the effectiveness of a combined programme on the musculoskeletal function of this population; 2) the development of a protocol to evaluate the feasibility and acceptability of a combined programme; and 3) a feasibility study conducted using a mixed methods approach to collect data to inform a definitive trial.
One pilot and two definitive trials (n=794) and two articles reporting additional data and outcome measures for one of the randomised controlled trials (RCTs) were included in the systematic review. Only mobility (a 6-minute walk test) at 6 months was possible to evaluate by meta-analysis and a pooled random effect of 15.05 (95% CI: -11.77 to 41.87) across two trials (with n=155 participants) did not support a combined intervention programme. Clear differences in relation to a reduced body weight and increased 6-minute walk test result in the intervention compared with the control groups were shown by narrative synthesis. However, the quality of the evidence was not clear. In addition, no UK studies were identified.
A single-centre feasibility study, consisting of one arm (a combined programme) with an embedded qualitative component (a focus group for participants and a questionnaire for physiotherapy staff), was conducted at the Royal Orthopaedic Hospital and the University of Birmingham. The programme was found to be acceptable and feasible for the target population and physiotherapy staff involved in terms of integration and expansion.
The results of the feasibility study may inform the design of future work to optimise diet and exercise interventions utilising a multimodal approach.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):