Analysis of anthropometric measurements and dietary intake in patients undergoing a multi-professional program osteoarthritis treatment (parqve – project arhtritis recovering quality of life by means of education)

Abstract

Purpose: To evaluate the effect of the care and educational multi-professional treatment in patients with knee osteoarthritis (KOA) by anthropometric measurements, variation of percentage of body fat, and questionnaires and correlate results obtained. Methods: One hundred and ninety-eight patients in usual treatment for KOA were randomized to 4 groups. All groups received a booklet and a DVD with information regarding KOA (causes and treatment modalities). Three groups (1,2 and 3) also attended two days of lectures 1,2 and 3 months apart, respectively. All groups were divided in subgroups A (bimonthly telephone calls) and B (no telephone calls). All patients were evaluated at baseline and at one year with height, weight (BMI estimation), waist and hip circumference (waist-hip ratio), percentage of body fat, through the measurement of seven skinfolds, calorie intake, from 24 hours recording, and asked to answer WOMAC, LEQUESNE, VAS and SF-36 questionnaires. Results: The waist-hip ratio showed a predominance of android obesity at baseline (89.4% of androids and 10.6% of ginecoids) and at one year (87.9% and 12.1% respectively) with no significant improvement (p=0.38). The average percentage of body fat decreased 0.44 from baseline to 12 months, regardless of group or telephone calls. Telephone calls determined average lower calorie intake at 12 months on group 1 (1005.4, CI 314.6,1696.3, p<0.001), and at 12 months Group 1A had on average lower calorie intake than the groups 2A (-781.8, CI -1472.7, -91.0, p=0.008) and 3A (-885.8, CI -1599.3, -172.2, p = 0.001). There was no correlation between calories intake and waist-hip ratio at baseline and reassessment with any of the questionnaires. BMI and percentage of body fat correlated with WOMAC, WOMAC pain, VAS and Lequesne scores at baseline and at reassessment. Only changes in BMI correlated weakly with one-year results of the WOMAC (r=-0.172, p=0.016), WOMAC pain (r=-0.193, p=0.007), LEQUESNE (r=-0.197, p=0.006) and SF-36-MCS (r=0.160, p=0.027); and with changes in WOMAC (r=0.220, p=0.002), WOMAC pain (r=0.199, p=0.006), VAS (r=0.170, p=0.018). Changes in porcentage of body fat did not correlate with any of the pain, function and quality of life changes. Conclusions: The multi-professional treatment improved percentage of body fat at one year. This improvement does not correlate with classes, telephone calls or improvements in pain, function and quality of life questionnaires (WOMAC, WOMAC pain, VAS, LEQUESNE and SF-36). Calorie intake improved and was influenced by telephone calls and classes one month apart, and does not correlate with changes in pain, function and quality of life. Changes in BMI correlated with changes in pain and function but not with quality of life.