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Causal mechanisms of a healthy lifestyle intervention for patients with musculoskeletal pain who are overweight or obese
journal contributionposted on 2023-02-16, 03:37 authored by A Williams, H Lee, SJ Kamper, KM O’Brien, J Wiggers, L Wolfenden, Serene YoongSerene Yoong, RK Hodder, EK Robson, R Haskins, JH McAuley, CM Williams
Purpose: To assess the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis, who are overweight or obese. Methods: We conducted causal mediation analyses of aggregated data from two randomized controlled trials (RCTs); which included 160 patients with chronic low back pain, and 120 patients with knee osteoarthritis. The intervention consisted of brief advice and referral to a six-month telephone-based healthy lifestyle coaching service. We used causal mediation to estimate the indirect, direct and path-specific effects of hypothesized mediators including: self-reported weight, diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Results: The intervention did not reduce weight, improve diet or physical activity or change pain beliefs, and these mediators were not associated with the outcomes. Sensitivity analyses showed that our estimates were robust to the possible effects of unknown and unmeasured confounding. Conclusions: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes.
Publication classificationC1.1 Refereed article in a scholarly journal
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Chronic low back painknee osteoarthritismediation analysisoverweightpainChronic PainDisability EvaluationExerciseHealth PromotionHealthy LifestyleHumansLow Back PainObesityOsteoarthritis, KneeOverweightPain MeasurementQuality of LifeWeight LossArthritisClinical Trials and Supportive ActivitiesClinical ResearchNutritionPain ResearchPreventionBehavioral and Social Science7 Management of diseases and conditions3.1 Primary prevention interventions to modify behaviours or promote wellbeing3 Prevention of disease and conditions, and promotion of well-being7.1 Individual care needsMetabolic and endocrineMusculoskeletalMedical and Health Sciences