Neuromuscular Exercise : A Novel Treatment To Reduce Symptoms And Joint Load In Medial Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$719,199.00
Summary
There is currently no cure for knee osteoarthritis (OA). Thus treatments are needed that not only reduce symptoms but also slow disease progression. Exercise is recommended for knee OA but traditional thigh muscle strengthening exercises do not appear to be effective in all cases and may not slow the disease. This project will compare novel 'neuromuscular exercise' and compare it to traditional strengthening exercise. The results have the potential to alter current exercise prescription
Young People With Old Knees: Knee Ligament Reconstruction And Early Joint Changes
Funder
National Health and Medical Research Council
Funding Amount
$782,727.00
Summary
Individuals who have undergone a knee reconstruction are at increased risk of knee osteoarthritis - 'younger people with older knees'. This may be partly due to increased knee load. This study aims to investigate whether muscle strength and activation as well as walking patterns influence changes in the knee joint structure as measured on magnetic resonance imaging. This may lead to rehabilitation strategies to address these factors so as to prevent the premature onset of knee osteoarthritis.
Reducing Knee Load And Slowing Disease Progression With Conservative Interventions In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$271,503.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the co ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for arthritis, interventions that slow progression of the disease will reduce the personal and societal burden of arthritis. Recently it has been postulated that specific exercise that targets how the muscles are controlled by the nervous system may have greater disease-modifying effects than exercise aimed at strengthening the muscles. Data are beginning to highlight the complexity of muscle strategies adopted by the nervous system to compensate for joint derangement in knee arthritis. It is our contention that there may be specific strategies that provide more optimal knee joint loading in relation to slowing disease progression. The first part of this project is to investigate knee control in people with knee arthritis and to evaluate whether this influences disease progression. This will provide the basis for refinement and optimisation of rehabilitation interventions for this patient group. The second part of this project will investigate whether strengthening the hip muscles in patients with knee arthritis influences knee load and hence disease progression. Hip muscle strengthening is currently not routinely included as part of the management of knee arthritis. If the results of this project find it to be effective, then hip muscle strengthening can be recommended for treating knee arthritis.Read moreRead less
Effects Of Laterally Wedged Insoles On Symptoms And Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$480,850.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow di ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow disease progression in certain patients, in addition to managing symptoms. However, to date there has been little quality research investigating the effectiveness of insoles in knee arthritis. This study aims to see whether 12 months of wearing insoles can lead to improvements in knee pain and function and slow disease progression in 200 people with knee arthritis. It will use state-of-the-art technology, magnetic resonance imaging, to measure changes in the amount of knee cartilage. This research is timely and the findings will be of major significance as there is increasing world-wide attention on slowing progression of knee arthritis. Insoles are one of the few non-drug therapies with the potential to influence both symptoms and disease progression. If the results show that insoles are beneficial, then this research will: 1. Better inform clinical guidelines to firmly recommend insoles to manage knee arthritis 2. Provide the basis for developing education strategies for health care practitioners and patients about the benefits of insoles 3. Provide the impetus to make insoles more readily available directly to patients 4. Ultimately lead to better patient outcomesRead moreRead less
Efficacy Of A Physiotherapy Treatment For Knee Joint Osteoarthritis: A Randomised, Double-blind, Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$156,743.00
Summary
Osteoarthritis of the knee is a disabling condition affecting the lining of the joints giving rise to pain and stiffness. It is common in older individuals and is a major cause of disability. Physiotherapy is often used to decrease pain and improve muscle strength and functional ability. However, there are few well controlled scientific studies which prove the efficacy of physiotherapy as a form of treatment in this condition. This project aims to establish whether a 12 week course of physiother ....Osteoarthritis of the knee is a disabling condition affecting the lining of the joints giving rise to pain and stiffness. It is common in older individuals and is a major cause of disability. Physiotherapy is often used to decrease pain and improve muscle strength and functional ability. However, there are few well controlled scientific studies which prove the efficacy of physiotherapy as a form of treatment in this condition. This project aims to establish whether a 12 week course of physiotherapy treatment is effective in reducing pain and improving function in 50-80 year old individuals diagnosed with osteoarthritis of the knee joint. It will also assess whether any improvements seen after treatment can be maintained with a home program. This will provide scientific evidence to justify the role of physiotherapy management in this condition.Read moreRead less
Does Vitamin D Supplementation Prevent Progression Of Knee Osteoarthritis? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,016,758.00
Summary
Observational evidence suggests that vitamin D deficiency may have a role in the causes of osteoarthritis (OA) and there are biologically plausible mechanisms to explain this. There is, however, no evidence which shows that intervening with vitamin D supplementation can slow the progression of OA. This study will compare knee OA structural changes in patients receiving vitamin D supplementation with those receiving a placebo. Use of MRI will provide sensitive measures of knee OA changes.
Effect Of Lifestyle Factors On Knee Cartilage Volume And Rate Of Cartilage Loss In A Normal Population
Funder
National Health and Medical Research Council
Funding Amount
$236,500.00
Summary
Osteoarthritis (OA) has been described by the WHO as a potential epidemic and a major health and care services cost driver in an aging society. OA has the largest impact on burden of disease borne in later life. This has been acknowledged by its listing as the 7th health priority in Australia. To date, most research has focused on treating the resulting pain and disability. However, in order to reduce the burden of OA, identifying modifiable risk factors in the normal population is important. Th ....Osteoarthritis (OA) has been described by the WHO as a potential epidemic and a major health and care services cost driver in an aging society. OA has the largest impact on burden of disease borne in later life. This has been acknowledged by its listing as the 7th health priority in Australia. To date, most research has focused on treating the resulting pain and disability. However, in order to reduce the burden of OA, identifying modifiable risk factors in the normal population is important. This proposal aims to identify life-style factors, such as diet, physical activity and obesity that effect knee cartilage health in healthy subjects, thereby identifying potential targets for future prevention of OA. This will provide us with the opportunity to promote a better quality of life as people age and reduce the economic burden on the community.Read moreRead less
Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious ....Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious side effects such as stomach ulcers and increased cardiovascular events (such as heart attacks). Fish oil has possible benefits in OA as it decreases pain and inflammation in rheumatoid arthritis (RA, another type of arthritis with joint inflammation and swelling), less use of NSAID in patients with RA, and in laboratory experiments may reduce cartilage breakdown in OA. It is likely that fish oil will have few side effects and decrease blood cholesterol. Many people with OA are already taking fish oil, however, there is no studies to know if it is effective in OA. The aim of this proposal is to study the effect of fish oil on pain and progression of knee OA, by doing a randomised clinical trial. Participants with knee OA will be given either high dose fish oil or similar oil with low levels of fish oil. The study will run for 2 years and during that time, we will measure pain and blood levels of fatty acids (part of the fish oil) and cholesterol. At the beginning and end of the study, magnetic resonance imaging (MRI) of the knee, a knee xray, and bone density testing will be done. The outcomes of the study will be to determine if fish oil affects pain and function (measured by questionnaires) and progression of OA (measured by cartilage changes on MRI). If fish oil is shown to reduce pain and disability and cartilage loss in OA, it will provide Australians with OA an alternative treatment that is low in side effects with positive effects on cardiovascular disease.Read moreRead less
In Vivo Patellofemoral Joint Measurement Using Kinematic Radiostereometric Analysis (RSA)
Funder
National Health and Medical Research Council
Funding Amount
$141,000.00
Summary
Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between peo ....Complications following total knee joint replacement continue to be a major cause for revision surgery and leads to a significant financial burden in terms of health care expenditure. Recent studies suggest that many of these complications are associated with post-surgical pain from the patella knee cap joint, commonly termed anterior knee pain (AKP). Post-surgery AKP may be influenced by the motion of the patella. Recent prospective, randomised trials have compared clinical outcomes between people with TKA in which the patellar surface is replaced (patellar resurfacing) or retained, but have been unable to accurately account for differences in patellar movement in those people with post-surgery complications. To date, studies of patellar motion after total knee replacement have been limited to two-dimensional analyses. This study addresses the technological limitations of previous trials by utilising accurate techniques for directly measuring skeletal motion using kinematic radiostereometric analysis (RSA). These data will measure patellar kinematics in three-dimensions for the first time. This information will allow optimisation of the design of TKA and the surgical techniques required for their implantation. Furthermore, the results will assist in the identification of surgical indications for patellar resurfacing, and the kinematic factors associated with anterior knee pain following total knee replacement surgery.Read moreRead less