Randomized trial assessing the impact of a musculoskeletal intervention for pain before participating in a weight management program

摘要

Purpose: Obesity increases the risk of developing physical disability and pain. Persons with a body mass index (BMI) of 30 kg/m2 or more have an increased risk for osteoarthritis compared with those with a BMI between 25 and 29 kg/m2. The Purpose of this study was to examine the effect of treatment directed at reducing musculoskeletal pain on weight loss in obese subjects prior to participation in a 6-month weight management (WM) program. Methods: Subjects (BMI ≥30 kg/m2; n = 54, female = 41, male = 13) with musculoskeletal pain, as assessed by a visual analog scale score of more than 5, were randomized to a physician musculoskeletal evaluation with treatment and physical therapy prior to participation in a 6-month WM program (intervention) or direct entry into the WM program (control) between November 10, 2003, and January 20, 2005. Results: Seventy-six percent of subjects completed the study (intervention, n = 18 [67%]; control, n = 23 [85%], P = .10). The intervention group demonstrated a significant decrease in visual analog scale score after musculoskeletal therapy (2.3 ± 1.8, P .0001). Despite a reduction in pain levels in the intervention group compared with the control group at the start of the WM program, there were no significant differences between the groups in percentage weight loss (P = .80), body fat omposition (P = .20), or BMI (P = .06), all significantly improved in both groups. Conclusions: usculoskeletal and physical therapy intervention directed at decreasing musculoskeletal pain in obese individuals prior to participation in a WM program reduces reported musculoskeletal pain for those participants completing the program but does not significantly improve weight loss over 6 months, compared with individuals with comparable musculoskeletal pain who enter directly into a WM program.