Collaborative Lifestyle Intervention Program in Knee Osteoarthritis Patients

Knee OA is a chronic, progressive, degenerative disease that affects over 20 million
Americans, and is cited as the primary cause for activity restriction and physical disability
in older adults. The joint damage and symptoms (i.e., pain, stiffness, and fatigue)
accompanying symptomatic knee OA result in activity restriction, muscle atrophy, reduced
quality of life and difficulty in performance of functional tasks.

Despite the well-established benefits of the Arthritis Foundation's (AF) exercise programs,
recent evidence suggests that lifestyle interventions combining Exercise and Dietary Weight
Loss (EX+DWL) results in superior improvements in key clinical outcomes in older, overweight
or obese knee OA patients.

Primary Aim: To compare the effects of a novel community-based EX+DWL program to AF's Walk
with Ease (WWE) EX intervention on improved mobility in knee osteoarthritis (OA) patients.

Secondary Aim: To compare the cost effectiveness and effects of the EX+DWL and WWE
interventions on weight loss, pain, and quality of life.

Inclusion Criteria:

- Diagnosed with knee OA: physician documented radiographic tibiofemoral OA of one or
both knees

- Overweight or Obese: BMI >25 and <40

- Knee Pain and Risk for Mobility Disability: self-reported difficulty walking ¼ mile,
climbing stairs, lifting or carrying groceries, or performing other household
activities due to knee pain

- Sedentary: sedentary lifestyle defined as currently participating < 20 minutes of
weekly structured moderate intensity exercise occurring in bouts >10 min

- Health Status: all participants must be free of severe heart or systemic disease that
would make moderate intensity exercise participation unsafe

- Age: > 60 years of age

- Stability of Residence: does not plan to move out of the Columbus metropolitan area
for the duration of the study

- Consents: willing to give an informed consent and sign a HIPPA authorization form; (9)
Physician Consent: treating rheumatologist and primary care physician provide medical
consent for participation

- Agreeableness: willing to accept randomization and complete all assessment and
intervention procedures

Exclusion Criteria:

- Health Status: any serious medical condition that precludes safe participation in an
exercise program

- Study Staff Judgment: Inability to complete the study protocol, in the opinion of the
study staff, due to frailty, illness, or other reasons