Barrow DR, Abbate LM, Paquette MR, et al. Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review. BMC Musculoskelet Disord. 2019 Dec 20;20(1):610. doi: 10.1186/s12891-019-3004-3. (Systematic review)

BACKGROUND: The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis.

METHODS: A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain.

RESULTS: Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups.

CONCLUSION: Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.

Discipline Area Score
Rehab Clinician (OT/PT) 5 / 7
Comments from MORE raters

Rehab Clinician (OT/PT) rater

This is a useful review of current evidence for exercise prescription in the management of pain and function management in middle aged obese patients.

Rehab Clinician (OT/PT) rater

The systematic review seemed underpowered as it only included 7 articles. The recommendations given for obese or arthritic patients were not different from those for healthy deconditioned individuals. The recommendations to start slow and build up intensity and duration should already be common knowledge among healthcare providers.
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