Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review

BMC Musculoskelet Disord. 2019 Dec 20;20(1):610. doi: 10.1186/s12891-019-3004-3.


Background: The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis.

Methods: A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain.

Results: Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups.

Conclusion: Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.

Keywords: Musculoskeletal pain; Obesity; Physical activity; Physical function.

Publication types

  • Systematic Review

MeSH terms

  • Exercise*
  • Humans
  • Obesity / complications
  • Obesity / therapy*
  • Osteoarthritis / etiology
  • Osteoarthritis / prevention & control*
  • Randomized Controlled Trials as Topic
  • Weight Reduction Programs*