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Zmerly H, Milanese C, El Ghoch M, Itani L, Tannir H, Kreidieh D, Yumuk V, Pellegrini M. Personalized Physical Activity Programs for the Management of Knee Osteoarthritis in Individuals with Obesity: A Patient-Centered Approach. Diseases 2023; 11:182. [PMID: 38131988 PMCID: PMC10742871 DOI: 10.3390/diseases11040182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Physical activity (PA) plays a vital role in knee osteoarthritis (KOA) management. However, engaging individuals with KOA in regular exercise is challenging, especially when they are affected by obesity. The aim of the current review is to elucidate how to increase adherence to exercise in this population. When implementing a PA program with patients with KOA and obesity, a specific multi-step approach can be adopted. In phase I (the baseline assessment), the patients' eligibility for exercise is ascertained and a physical fitness assessment, sarcopenic obesity screening and quantification of the pain experienced are undertaken. Phase II adopts a patient-centered approach in implementing a PA program that combines an active lifestyle (>6000 steps/day) with land- or water-based exercise programs performed over eight to twelve weeks, with a frequency of three to five sessions per week, each lasting 60 min. In phase III, several strategies can be used to increase the patients' adherence to higher levels of PA, including the following: (i) personalizing PA goal-setting and real-time monitoring; (ii) enhancing physical fitness and the management of sarcopenic obesity; (iii) building a sustainable environment and a supportive social network for an active lifestyle; and (iv) reducing pain, which can ameliorate the clinical severity of KOA and help with weight management in this population.
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Affiliation(s)
- Hassan Zmerly
- Orthopaedics and Traumatology Unit, Villa Erbosa Hospital, 40129 Bologna, Italy;
- Ludes Campus, 6912 Lugano, Switzerland
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37131 Verona, Italy;
| | - Marwan El Ghoch
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 34363 Istanbul, Türkiye;
| | - Massimo Pellegrini
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
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