{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:59:34Z","timestamp":1792115974173,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatments aimed at improving physical function and body composition, including reducing fat mass (FM) and increasing muscle mass, may benefit individuals with advanced knee osteoarthritis (OA) and obesity. We investigated the feasibility and efficacy of a multimodal behavioural intervention compared to usual care to enhance physical function and muscle mass in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The POMELO (Prevention Of MusclE Loss in Osteoarthritis) study is a two\u2010arm pilot randomized controlled trial; NCT05026385. Participants aged 40\u201375\u2009years, with a BMI\u2009\u2265\u200935\u2009kg\/m<jats:sup>2<\/jats:sup> and knee OA were randomized 1:1 to either the intervention group (POMELO) or usual care (UC). The 3\u2010month POMELO intervention incorporated progressive resistance exercise (3 sessions\/week), individualized nutrition counselling targeted for OA, and 12 group education sessions on nutrition and arthritis self\u2010management. The UC group received standard clinical care. After the 3\u2010month supervised intervention, both groups were followed for 6\u2009months without support. Assessments at baseline, 3\u2009months and 9\u2009months (primary endpoint) included body composition (DXA, measuring FM and appendicular lean soft tissue [ALST]), physical function (chair\u2010sit\u2010to\u2010stands [CSTS], 6\u2010min walk [6MWT], maximal handgrip strength [HGS]), and health\u2010related quality of life (Euroqol visual analog scale [EQ\u20105D VAS]). Co\u2010primary outcomes were feasibility (intervention completion \u2265 80% and per\u2010protocol adherence \u2265 60% [i.e., attendance at 12 education sessions and exercise 3 \u00d7\/week]) and acceptability (4\u2010item Likert\u2010scale satisfaction survey, and open\u2010ended questions). Secondary outcomes included changes in physical function and ALST.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty participants were randomized (POMELO\u2009=\u200925, UC\u2009=\u200925), with 32 completing the study (69% female, mean age 64.9\u2009\u00b1\u20091.2\u2009years, BMI 42.1\u2009\u00b1\u20091.0\u2009kg\/m<jats:sup>2<\/jats:sup>). The POMELO intervention group had 80% completion and 74% adherence, confirming feasibility. Higher satisfaction rates were observed in POMELO compared to UC (3.5 vs. 2.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) indicating greater acceptability. The POMELO group had improvements in CSTS (mean difference [MD] 3.96, ES 1.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), 6MWT (MD 31.6\u2009m, ES 0.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) and EQ\u20105D VAS (MD 7.9 points, ES\u2009=\u20090.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) compared to UC. Both groups experienced FM loss, but only the UC group lost ALST and HGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The POMELO intervention, combining personalized nutrition, resistance exercise and self\u2010management support, was feasible, acceptable and showed greater efficacy than usual care to improve physical function in patients with knee OA and obesity. Our pilot study of this intervention showed potential benefits on body composition and quality of life without focusing on weight reduction. A larger study is needed to confirm these results, as this approach may offer advantages over usual care, potentially leading to better mobility and health outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.70025","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T06:51:39Z","timestamp":1754031099000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Improving Muscle Function Through a Multimodal Behavioural Intervention for Knee Osteoarthritis and Obesity: The POMELO Trial"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9520-4302","authenticated-orcid":false,"given":"Kristine","family":"Godziuk","sequence":"first","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Science Faculty of Agricultural, Life and Environmental Sciences, University of Alberta  Edmonton Canada"},{"name":"Department of Physical Therapy and Rehabilitation Science University of California  San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Forhan","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy Temerty Faculty of Medicine, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio\u00a0T.","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Science Faculty of Agricultural, Life and Environmental Sciences, University of Alberta  Edmonton Canada"},{"name":"Department of Pediatrics Faculty of Medicine and Dentistry, University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao\u00a0F.","family":"Mota","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition Federal University of Goias  Goi\u00e2nia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Werle","sequence":"additional","affiliation":[{"name":"Section of Orthopaedic Surgery, Department of Surgery University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John\u00a0A.","family":"Batsis","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine School of Medicine, University of North Carolina at Chapel Hill  Chapel Hill USA"},{"name":"Department of Nutrition Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo\u00a0M.","family":"Donini","sequence":"additional","affiliation":[{"name":"Experimental Medicine Department Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Siervo","sequence":"additional","affiliation":[{"name":"School of Population Health, Curtin University  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla\u00a0M.","family":"Prado","sequence":"additional","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Science Faculty of Agricultural, Life and Environmental Sciences, University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41142"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2020.9041"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.10.013"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22854"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2020.105114"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2020.00053"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","unstructured":"C. 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