Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

• Published in: Nutrients 2021-06, Vol.13 (6), p.1992
• Main Authors: Chu, Shu-Fen, Liou, Tsan-Hon, Chen, Hung-Chou, Huang, Shih-Wei, Liao, Chun-De
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Aging; Analysis; Arthritis; Biomedical materials; Body weight; Clinical trials; Combined treatment; Diet; Exercise; Exercise - physiology; exercise training; Fitness training programs; Follow-Up Studies; Humans; Intervention; Meta-analysis; Middle Aged; muscle mass; Muscle strength; Muscle Strength - physiology; Muscle, Skeletal - pathology; Muscle, Skeletal - physiopathology; Obesity; Older people; Online databases; Organ Size; Osteoarthritis; Osteoarthritis - complications; Osteoarthritis - physiopathology; Overweight; Overweight - complications; Overweight - physiopathology; Physical fitness; physical function; Physical therapy; Proteins; Publication Bias; Randomized Controlled Trials as Topic; Regression Analysis; Review; Risk; Risk analysis; Sarcopenia; Sarcopenia - complications; Sarcopenia - physiopathology; Therapeutics, Physiological; Treatment Outcome; Walking; Walking - physiology; Weight control; Working groups
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13061992

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4-8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.