Preventing mobility and physical activity impairments: a longitudinal, multifactorial investigation of knee osteoarthritis progression

A major threat to the health of Canadians is the chronic diseases that result from decreased physical activity. While heart health benefits of physical activity are known, there has been less recognition of the relationship of physical activity and bone and joint health. Improving musculoskeletal health can significantly reduce the trend toward physical inactivity. Osteoarthritis (OA) is a common disease that causes joint pain, stiffness and immobility, and leads to reduced physical activity and the development of other chronic health conditions. The number of Canadians with OA is expected to increase to almost 25% of the population by 2025, and those in the 45-54 year range are developing OA at a particularly alarming rate. The knee is the most common joint affected by OA. Knee OA management has focused on pain relief with drug therapies that do not halt or slow the disease process. This can create more problems because reducing pain was shown to increase joint loading and degeneration. While research has shown the importance of mechanical factors to knee OA, this information is rarely included in treatment guidelines or studies on risk factors. A better understanding of how physical activity, obesity, sex, joint alignment and other risk factors affect OA progression will help to improve this. Our work aims to address these gaps by examining multiple factors at once, and including information on joint loading and muscle strength to identify the combinations of factors that prevent or accelerate disease progression. For instance, women have a higher incidence of OA, and we aim to learn if there is a different set of risk factors for them than men. The new knowledge will be used in guidelines for OA prevention and early intervention focused on changing the loading environment of the joint. This research aims to break the cycle of physical inactivity, OA and chronic health problems that is creating a huge burden on individuals and the Canadian Health Care system.