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Randomized Trial Assessing the Impact of a Musculoskeletal Intervention for Pain Before Participating in a Weight Management Program

Snow, Richard DO; Ruane, Joseph DO; LaLonde, Michelle MA; Shaffer, Lynn MS; Kim, Brett MS; Graffagnino, Cheryl RD; Falko, James MD; Spencer, Kathy MSN; Caulin-Glaser, Teresa MD

Journal of Cardiopulmonary Rehabilitation and Prevention: May-June 2010 - Volume 30 - Issue 3 - p 173–180
doi: 10.1097/HCR.0b013e3181c565c8

PURPOSE Obesity increases the risk of developing physical disability and pain. Persons with a body mass index (BMI) of 30 kg/m2 or more have an increased risk for osteoarthritis compared with those with a BMI between 25 and 29 kg/m2. The purpose of this study was to examine the effect of treatment directed at reducing musculoskeletal pain on weight loss in obese subjects prior to participation in a 6-month weight management (WM) program.

METHODS Subjects (BMI ≥ 30 kg/m2; n = 54, female = 41, male = 13) with musculoskeletal pain, as assessed by a visual analog scale score of more than 5, were randomized to a physician musculoskeletal evaluation with treatment and physical therapy prior to participation in a 6-month WM program (intervention) or direct entry into the WM program (control) between November 10, 2003, and January 20, 2005.

RESULTS Seventy-six percent of subjects completed the study (intervention, n = 18 [67%]; control, n = 23 [85%], P = .10). The intervention group demonstrated a significant decrease in visual analog scale score after musculoskeletal therapy (2.3 ± 1.8, P < .0001). Despite a reduction in pain levels in the intervention group compared with the control group at the start of the WM program, there were no significant differences between the groups in percentage weight loss (P = .80), body fat composition (P = .20), or BMI (P = .06), all significantly improved in both groups.

CONCLUSIONS Musculoskeletal and physical therapy intervention directed at decreasing musculoskeletal pain in obese individuals prior to participation in a WM program reduces reported musculoskeletal pain for those participants completing the program but does not significantly improve weight loss over 6 months, compared with individuals with comparable musculoskeletal pain who enter directly into a WM program.

This study examined the effect of treatment directed at reducing musculoskeletal pain on weight loss in obese subjects prior to participation in a weight management (WM) program. The intervention reduced reported musculoskeletal pain but did not significantly improve weight loss over 6 months when compared with those directly entering WM.

McConnell Heart Health Center (Drs Snow and Caulin-Glaser and Mss LaLonde, Graffagnino, and Spencer and Mr Kim), McConnell Spine, Sport and Joint Center (Dr Ruane), and OhioHealth Research Institute (Ms Shaffer), Columbus, Ohio; and McConnell Heart Health Center and University of Colorado, Denver (Dr Falko).

Corresponding Author: Teresa Caulin-Glaser, MD, Preventive Cardiology and Research, McConnell Heart Health Center, 3773 Olentangy River Rd, Columbus, OH 43214 (

© 2010 Lippincott Williams & Wilkins, Inc.