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The intensive diet and exercise for arthritis (IDEA) trial: Design and rationale
BMC Musculoskeletal Disorders, 08/04/09

Messier SP et al. – Findings suggest that the IDEA trial has the potential to enhance our understanding of the osteoarthritis (OA) disease process, refine weight loss and exercise recommendations in this prevalent disease, and reduce the burden of disability.

• Study to test the hypothesis that intensive weight loss will reduce inflammation and joint loads sufficiently to alter disease progression, either with or w/o exercise in OA pts
• 450 overweight and obese (BMI = 27-40 kg/m2) older (age ≥ 55 yrs) adults with tibiofemoral OA
• Participants are randomized to one of three 18-mo interventions:
  1. Intensive dietary restriction-plus-exercise
  2. Exercise-only; or
  3. Intensive dietary restriction-only
• Primary aims: to compare the effects of these interventions on inflammatory biomarkers and knee joint loads
• Secondary aims were to examine:
  • Effects of these interventions on function, pain, and mobility
  • Dose response to weight loss on disease progression
  • If inflammatory biomarkers and knee joint loads are mediators of the interventions; and
  • Association between quadriceps strength and disease progression

• Test-retest reliability results indicated that the ICCs for knee joint load variables were excellent, ranging from 0.86 - 0.98
• Knee flexion/extension moments were most affected by BMI, with lower reliability with the highest tertile of BMI
• Reliability of the semi-quantitative scoring of the knee joint using MRI exceeded previously reported results, ranging from 0.66 for synovitis to 0.99 for bone marrow lesion size

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