Four RCTs that reporting five comparisons (n=454) were included. Quality score ranged from 2 to 3. Sample size varied from 21 to 160 patients.
Three RCTs (four comparisons) showed a significant weight loss of 6.1kg (95% CI 4.7kg to 7.6kg) and improved pain (SMD 0.2, 95% CI 0 to 0.39) and self-reported disability (SMD 0.23, 95% CI: 0.04 to 0.42). Heterogeneity was reasonably high, but was not statistically significant (I2=47.2% for pain and I2=39.7% for disability). Studies that reported Lequence disease Index showed non-significant and inconsistent clinical outcomes.
Percentage body weight change and rate of weight change per week were significant predictors of self-reported disability, but not for changes in pain scores.