Many persons with osteoarthritis (OA) are overweight or obese, a factor known to increase pain anddisability. Past work suggests that two psychosocial treatments may be beneficial for patients withOA: lifestyle behavioral weight management and pain coping skills training. We are currentlyconducting the first randomized clinical trial testing the separate and combined effects of theseinterventions in a sample of osteoarthritis patients who are overweight or obese/overweight (BMI>25<42). By the end of the current funding period we will have completed the treatment phase of thisstudy. In this renewal application we seek funding for two studies focused on maintenance oftreatment gains in this study sample. Study 1 seeks to complete 6- and 12-months follow-up datacollection of patients in this study. Data analyses will examine the effects of treatment on long-termfollow-up and will examine potential predictors of long-term improvements in pain, physical disability,psychological disability, joint stiffness, activity, gait, and markers of systematic inflammation. Study 2seeks to collect data on novel patient characteristics (responsiveness of pain and distress to foodintake, genetic markers of pain sensitivity) that may predict maintenance of treatment gains in thissample of overweight/obese OA patients. Our clinical observations and data from animal and humanmodels suggest that food intake may provide acute relief from pain and distress. Although increasingfood intake may provide acute relief, it likely contributes to detrimental long-term effects such asweight gain, increased pain, inflammation and disability. Study 2 will employ a case-control withinsubjects design patients who had participated in Study 1. This design compares levels of pain anddistress that occur after eating and after control periods of the day. Participants will record their foodintake and also be prompted throughout the day by programmed auditory signals to make pain anddistress entries in structured diary booklets. Study 2 has two goals: 1) to examine whether food intakeis related to decreases in pain and distress, and 2) to determine whether the strength of thisrelationship predicts pain, BMI, and other OA-related outcomes six months later. In Study 2 bloodsamples also will be collected and stored for later genetic analysis that will enable us to examine howmarkers of pain sensitivity relate to short- and long-term treatment outcomes.
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