{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T22:23:35Z","timestamp":1772490215965,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","award":["NIHR\u2010RP\u20102014\u2010026"],"award-info":[{"award-number":["NIHR\u2010RP\u20102014\u2010026"]}],"id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","award":["NIHR\u2010RP\u2010011\u2010015"],"award-info":[{"award-number":["NIHR\u2010RP\u2010011\u2010015"]}],"id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although exercise is a core treatment for people with knee osteoarthritis (OA), it is currently unknown whether those with additional comorbidities respond differently to exercise than those without. We explored whether comorbidities predict pain and function following an exercise intervention in people with knee OA, and whether they moderate response to: exercise versus no exercise; and enhanced exercise versus usual exercise\u2010based care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook analyses of existing data from three randomized controlled trials (RCTs): TOPIK (<jats:italic>n<\/jats:italic> = 217), APEX (<jats:italic>n<\/jats:italic> = 352) and Benefits of Effective Exercise for knee Pain (BEEP) (<jats:italic>n<\/jats:italic> = 514). All three RCTs included: adults with knee pain attributable to OA; physiotherapy\u2010led exercise; data on six comorbidities (overweight\/obesity, pain elsewhere, anxiety\/depression, cardiac problems, diabetes mellitus and respiratory conditions); the outcomes of interest (six\u2010month Western Ontario and McMaster Universities Arthritis Index knee pain and function). Adjusted mixed models were fitted where data was available; otherwise linear regression models were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Obesity compared with underweight\/normal body mass index was significantly associated with knee pain following exercise, as was the presence compared with absence of anxiety\/depression. The presence of cardiac problems was significantly associated with the effect of enhanced versus usual exercise\u2010based care for knee function, indicating that enhanced exercise may be less effective for improving knee function in people with cardiac problems. Associations for all other potential prognostic factors and moderators were weak and not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obesity and anxiety\/depression predicted pain and function outcomes in people offered an exercise intervention, but only the presence of cardiac problems might moderate the effect of exercise for knee OA. Further confirmatory investigations are required.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1425","type":"journal-article","created":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T08:45:34Z","timestamp":1576313134000},"page":"3-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Do comorbidities predict pain and function in knee osteoarthritis following an exercise intervention, and do they moderate the effect of exercise? Analyses of data from three randomized controlled trials"],"prefix":"10.1002","volume":"18","author":[{"given":"Amardeep","family":"Legha","sequence":"first","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle L.","family":"Burke","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"},{"name":"Centre for Prognosis Research, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine E.","family":"Foster","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"},{"name":"Keele Clinical Trials Unit, Faculty of Medicine and Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle A.","family":"van der Windt","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"},{"name":"Centre for Prognosis Research, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan G.","family":"Quicke","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma L.","family":"Healey","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos","family":"Runhaar","sequence":"additional","affiliation":[{"name":"Department of General Practice Erasmus MC University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0374-2862","authenticated-orcid":false,"given":"Melanie A.","family":"Holden","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care &amp; Health Sciences Keele University  Keele UK"},{"name":"Keele Clinical Trials Unit, Faculty of Medicine and Health Sciences Keele University  Keele UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,14]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1833","article-title":"Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee","volume":"15","author":"Bellamy N.","year":"1988","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta5330"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7141"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22504"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23013"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/PHM.0000000000000448","article-title":"Barriers and facilitators to exercise participation in people with hip and\/or knee osteoarthritis: Synthesis of the literature using behavior change theory","volume":"95","author":"Dobson F.","year":"2016","journal-title":"American Journal of Physical Medicine and Rehabilitation"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(70)90054-8"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39280.509803.BE"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3310\/pgfar06040"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38977.590752.0B"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5793"},{"key":"e_1_2_11_15_1","first-page":"e018971","article-title":"Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA): A systematic review update and individual participant data meta\u2010analysis protocol","volume":"7","author":"Holden M. 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