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 ± 5.9 kg (−7.9 ± 5.9%)] lost significantly more weight than PACE [−2.5 ± 2.7 kg (−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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 472-478 |
| Number of pages | 7 |
| Journal | Obesity Research and Clinical Practice |
| Volume | 12 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2018 |
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Keywords
- Intervention
- Surgery
- Weight loss
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics
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Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement : A pilot study. / Pellegrini, Christine A.; Chang, Rowland W.; Dunlop, Dorothy D.; Conroy, David E.; Lee, Jungwha; Van Horn, Linda; Spring, Bonnie; Cameron, Kenzie A.
In: Obesity Research and Clinical Practice, Vol. 12, No. 5, 01.09.2018, p. 472-478.Research output: Contribution to journal › Article
TY - JOUR
T1 - Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement
T2 - A pilot study
AU - Pellegrini, Christine A.
AU - Chang, Rowland W.
AU - Dunlop, Dorothy D.
AU - Conroy, David E.
AU - Lee, Jungwha
AU - Van Horn, Linda
AU - Spring, Bonnie
AU - Cameron, Kenzie A.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - 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 ± 5.9 kg (−7.9 ± 5.9%)] lost significantly more weight than PACE [−2.5 ± 2.7 kg (−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.
AB - 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 ± 5.9 kg (−7.9 ± 5.9%)] lost significantly more weight than PACE [−2.5 ± 2.7 kg (−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.
KW - Intervention
KW - Surgery
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=85049630442&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049630442&partnerID=8YFLogxK
U2 - 10.1016/j.orcp.2018.06.009
DO - 10.1016/j.orcp.2018.06.009
M3 - Article
C2 - 30007535
AN - SCOPUS:85049630442
VL - 12
SP - 472
EP - 478
JO - Obesity Research and Clinical Practice
JF - Obesity Research and Clinical Practice
SN - 1871-403X
IS - 5
ER -