Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study

Christine A. Pellegrini; Rowland W. Chang; Dorothy D. Dunlop; David E. Conroy; Jungwha Lee; Linda Van Horn; Bonnie Spring; Kenzie A. Cameron

doi:10.1016/j.orcp.2018.06.009

Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study

Christine A. Pellegrini^*, Rowland W. Chang, Dorothy D. Dunlop, David E. Conroy, Jungwha Lee, Linda Van Horn, Bonnie Spring, Kenzie A. Cameron

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

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	https://doi.org/10.1016/j.orcp.2018.06.009
State	Published - Sep 1 2018

Funding

This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH’s NCATS (UL1TR001422). This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH's NCATS (UL1TR001422).

Keywords

Intervention
Surgery
Weight loss

ASJC Scopus subject areas

Nutrition and Dietetics
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.orcp.2018.06.009

Cite this

@article{7594445546194f158183bfdd349a7323,

title = "Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study",

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.",

keywords = "Intervention, Surgery, Weight loss",

author = "Pellegrini, {Christine A.} and Chang, {Rowland W.} and Dunlop, {Dorothy D.} and Conroy, {David E.} and Jungwha Lee and {Van Horn}, Linda and Bonnie Spring and Cameron, {Kenzie A.}",

note = "Funding Information: This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH{\textquoteright}s NCATS (UL1TR001422). Funding Information: This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH's NCATS (UL1TR001422). Publisher Copyright: {\textcopyright} 2018 Asia Oceania Association for the Study of Obesity",

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doi = "10.1016/j.orcp.2018.06.009",

language = "English (US)",

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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.

N1 - Funding Information: This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH’s NCATS (UL1TR001422). Funding Information: This study was supported by K12HS023011 from the AHRQ and P60-AR064464 from the NIAMs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or NIAMS. Study data were collected and managed using REDCap hosted at Feinberg School of Medicine by Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the NIH's NCATS (UL1TR001422). Publisher Copyright: © 2018 Asia Oceania Association for the Study of Obesity

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

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Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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