title: Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight.
abstract: OBJECTIVE
  The objective of this review was to construct an updated evidence-based clinical practice guideline on the use of physical activity and diet for the management of osteoarthritis (OA) in adults (>18 years of age) who are obese or overweight (body mass index ≥25 kg/m(2)).
  
  
  METHODS
  Articles were extracted from the following databases: MEDLINE, EMBASE (Current Contents), SPORTDiscus, SUM, Scopus, CINAHL, AMED, BIOMED, PubMed, ERIC, the Cochrane Controlled Trials, and PEDro.
  
  
  METHODS
  The Ottawa Panel and research assistance team strictly applied the inclusion and exclusion criteria from previous Ottawa Panel publications.
  
  
  METHODS
  An a priori literature search was conducted for articles related to obesity and OA of the lower extremities that were published from January 1, 1966, to November 30, 2010. Inclusion criteria and the methods to grade the recommendations were created by the Ottawa Panel.
  
  
  RESULTS
  
  
  
  CONCLUSIONS
  were graded based on the strength of evidence (A, B, C, C+, D, D+, or D-) as well as experimental design (I for randomized controlled trials and II for nonrandomized studies). In agreement with previous Ottawa Panel methods, Cochrane Collaboration methods were utilized for statistical analysis. Clinical significance was established by an improvement of ≥15% in the experimental group compared with the control group. There were a total of 79 recommendations from 9 articles. From these recommendations, there were 36 positive recommendations: 21 grade A and 15 grade C+. There were no grade B recommendations, and all recommendations were of clinical benefit.
  
  
  CONCLUSIONS
  Further research is needed, as more than half of the trials were of low methodological quality.
  
  
  CONCLUSIONS
  This review suggests that physical activity and diet programs are beneficial, specifically for pain relief (9 grade A recommendations) and improved functional status (6 grade A and 7 grade C+ recommendations), for adults with OA who are obese or overweight. The Ottawa Panel was able to demonstrate that when comparing physical activity alone, diet alone, physical activity combined with diet, and control groups, the intervention including physical activity and diet produced the most beneficial results.
authors.affiliation: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Montfort Hospital Research Institute, Ottawa, Ontario, Canada. lbrossea@uottawa.ca
authors.forename: Lucie
authors.initials: L
authors.lastname: Brosseau
authors.forename: George A
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authors.lastname: Wells
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authors.lastname: Tugwell
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authors.forename: Claire-Jehanne
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authors.lastname: Dubouloz
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authors.forename: Vivian A
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authors.lastname: De Angelis
authors.forename: Lilliane
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authors.lastname: Francoeur
authors.forename: Sarah
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authors.lastname: Milne
authors.forename: Laurianne
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authors.lastname: Loew
authors.forename: Jessica
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authors.lastname: McEwan
authors.forename: Steven P
authors.initials: SP
authors.lastname: Messier
authors.forename: Eric
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authors.lastname: Doucet
authors.forename: Glen P
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authors.lastname: Kenny
authors.forename: Denis
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authors.lastname: Prud'homme
authors.forename: Sydney
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authors.lastname: Lineker
authors.forename: Mary
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authors.lastname: Bell
authors.forename: Stéphane
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authors.lastname: Poitras
authors.forename: Jing Xian
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authors.lastname: Li
authors.forename: Hillel M
authors.initials: HM
authors.lastname: Finestone
authors.forename: Lucie
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authors.lastname: Laferrière
authors.forename: Angela
authors.initials: A
authors.lastname: Haines-Wangda
authors.forename: Marion
authors.initials: M
authors.lastname: Russell-Doreleyers
authors.forename: Kim
authors.initials: K
authors.lastname: Lambert
authors.forename: Alison D
authors.initials: AD
authors.lastname: Marshall
authors.forename: Margot
authors.initials: M
authors.lastname: Cartizzone
authors.forename: Adam
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authors.lastname: Teav
mesh_terms: D004032:Diet; D019317:Evidence-Based Medicine; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D009765:Obesity / Q000150:complications*; D009864:Ontario; D010003:Osteoarthritis / Q000150:complications / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D050177:Overweight / Q000150:complications*; D026741:Physical Therapy Modalities