Evidence map›Paper›PMID 37128836›Full record

Trial reportArthritis care & research2023

How Does Exercise, With and Without Diet, Improve Pain and Function in Knee Osteoarthritis? A Secondary Analysis of a Randomized Controlled Trial Exploring Potential Mediators of Effects.

Belinda J Lawford, Rana S Hinman, Fiona McManus, Karen E Lamb, Thorlene Egerton, Catherine Keating, Courtney Brown, Kathryn Oliver, Kim L Bennell

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Trial
  3. Review
  4. Article
  5. Five-Year Impact of Weight Loss on Knee Pain and Quality of Life in Obese Patients.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Belinda J LawfordThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-0392-6058
Rana S HinmanThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0001-6368-9456
Fiona McManusThe University of Melbourne, Melbourne, Victoria, Australia.
Karen E LambThe University of Melbourne, Melbourne, Victoria, Australia.
Thorlene EgertonThe University of Melbourne, Melbourne, Victoria, Australia.
Catherine KeatingMedibank Private, Melbourne, Victoria, Australia.
Courtney BrownMedibank Private, Melbourne, Victoria, Australia.
Kathryn OliverThe University of Melbourne, Melbourne, Victoria, Australia.
Kim L BennellThe University of Melbourne, Melbourne, Victoria, Australia.
The University of Melbourne · AUIP Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore the mediators of effects of two 6-month telehealth-delivered exercise programs, including exercise with and without weight-loss diet, on pain and function improvements in knee osteoarthritis (OA).

methodsSecondary analysis of 345 participants from a 3-arm randomized controlled trial of exercise (Exercise program) and exercise plus diet (Diet + Exercise program) versus information (Control program) was conducted. Outcomes were changes in pain (11-point numeric rating scale) and function (Western Ontario and McMaster Universities Osteoarthritis Index [score range 0-68]) at 12 months. Potential mediators were change at 6 months in attitudes toward self-management, fear of movement, arthritis self-efficacy, weight, physical activity, and willingness for knee surgery. For the Diet + Exercise program versus the Exercise program, only change in weight was evaluated.

resultsPossible mediators of the Exercise program versus the Control program included reduced fear of movement (accounting for -1.11 units [95% confidence interval (95% CI) -2.15, -0.07] improvement in function) and increased arthritis self-efficacy (-0.40 units [95% CI -0.75, -0.06] reduction in pain, -1.66 units [95% CI -3.04, -0.28] improvement in function). The Diet + Exercise program versus the Control program mediators included reduced fear of movement (-1.13 units [95% CI -2.17, -0.08] improvement in function), increased arthritis self-efficacy (-0.77 units [95% CI -1.26, -0.28] reduction in pain, -5.15 units [95% CI -7.34, -2.96] improvement in function), and weight loss (-1.20 units [95% CI -1.73, -0.68] reduction in pain, -5.79 units [95% CI -7.96, -3.63] improvement in function). Weight loss mediated the Diet + Exercise program versus the Exercise program (-0.89 units [95% CI -1.31, -0.47] reduction in pain, -4.02 units [95% CI -5.77, -2.26] improvement in function).

conclusionIncreased arthritis self-efficacy, reduced fear of movement, and weight loss may partially mediate telehealth-delivered exercise program effects, with and without diet, on pain and/or function in knee OA. Weight loss may partially mediate the effect of diet and exercise compared to exercise alone.

Indexed as

Osteoarthritis, KneeDiet, ReducingExerciseExercise TherapyHumansPainTreatment OutcomeWeight Loss

Identifiers

PMID37128836
PMCPMC10952828
OpenAlexW4367668203

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.