None listed
Conditions
Brief summary
This study will look at the Feasibility of delivering Physiotherapy and Dietetics intervention via a hybrid format (online and face to face) for patients with end stage knee osteoarthritis referred to a public hospital for surgical opinion. The study will focus on patients with a Body Mass Index >35kg/m2. We think it is feasible to deliver this intervention in a hybrid format for this patient group. The secondary aim is to determine if this combined treatment is effective in this format. We will look at weight loss and functional improvement to determine this.
Interventions
6 sessions of a Physiotherapist over 12 weeks - 60minutes initial with 30 minutes review. Hybrid delivery, face to face and telehealth
6 Sessions with a Dietician over 12 weeks - very low calorie diet. Hybrid delivery, face to face and telehealth. The first session is face-to-face then the participant deicides if future sessions at telehealth or face-to-face.
SMS reminders for appointments will be utilised
Patient will receive dietetics and physiotherapy at same time. Participants will compl
6 sessions of a Physiotherapist over 12 weeks - 60minutes initial with 30 minutes review. Hybrid delivery, face to face and telehealth 6 Sessions with a Dietician over 12 weeks - very low calorie diet. Hybrid delivery, face to face and telehealth. The first session is face-to-face then the participant deicides if future sessions at telehealth or face-to-face. SMS reminders for appointments will be utilised Patient will receive dietetics and physiotherapy at same time. Participants will complete food diary and attendance checklists each session. Physiotherapy intervention will be neuromuscular exercise based around the patients' goals (squats, stairs, lunges). They will use Numerical Pain Rating to define intensity and apply American College of Sports Medicine exercise principles for resistance training. The sessions will be one to one. Fortnightly sessions, new assessment 60 minutes, reviews will be 30 minutes. Goal setting will be done by dieticians, and a Very Low-Calorie Diet (VLCD) will be the intervention. Participants will make and purchase meals The Very Low-Calorie Diet prescribes the daily caloric intake, which is approximately 800 calories per day. Neuromuscular exercise will be completed twice a week at a minimum; advice will be provided to also aim for 30 minutes of cardiovascular exercise most days of the week (walk/swim/ride)
Sponsors
Darling Downs Health
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Body Mass index >35 kg/m2 - Symptomatic end stage radiographic knee osteoarthritis as deemed by the booking orthopaedic medical officer (Kellgren and Lawrence Grade 3-4) - Oxford Knee Score <20, severe functional impairment
Exclusion criteria
- Unable to undertake very low-calorie diet without close medical supervision o Diagnosis of type 1 diabetes o Warfarin use o Stroke or cardiac event in the past six months o Unstable cardiovascular condition o Fluid intake restriction o Renal problems (unless GP clearance and estimated glomerular filtration rate >30ml/min/1.73M2 - already actively trying to lose weight by any of the following mechanisms: o using meal replacements for weight loss o using structured meal programs for weight loss such as ‘Lite n’ Easy’ - Self-reported inflammatory arthritis - Previous arthroplasty to affected knee - Previous knee surgery within the last 6 months - Prior extensive (>3 months) trial of physiotherapy led exercise and dietitian led dietary intervention. - Inability to speak and read English - Pregnancy or planned pregnancy - On waiting list for/planning bariatric surgery in next 12 months - Vegan dietary requirements due to complexity of delivering a nutritionally complete diet within a very low-calorie diet regime - <18 years of age - Inability to provide informed consent
Outcome results
None listed