Validating the existence of high risk gait patterns that are predictive for structural and symptom progression and their implication for physical activity: A study of the interrelationship among physical activity, biomechanical and neuromuscular characteristics related to long term and short term knee osteoarthritis progression outcomes.

Maintaining a physically active lifestyle requires healthy leg muscles, bones, and joints. Osteoarthritis (OA), a disease that damages the joints of the body, results in significant pain that decrease people's physical abilities, making them more prone to chronic health problems. Specifically knee OA is reaching epidemic proportions in Canada, posing a substantial personal, health care and economic burden. There is presently no cure, thus a need to improve knee OA management to reduce pain, slow joint damage and thwart the need for knee joint replacement surgeries. Physical activity, such as walking is recommended for preventing and treating chronic disease, including OA, but large knowledge gaps in how to apply this information to people with knee OA exist. Simple questions like "How much physical activity is ok for those with knee OA?" are not easily answered. Over the last decade, our work has broke new ground in understanding how the knee works during walking and the changes that occur as knee OA pain or joint damage worsens. Recently, we also discovered that how people walk (walking patterns) had potential to predict who progressed to knee joint replacement or had more rapid damage to their joints over a 5-10 year period. Our aim is to understand why knee OA progresses in some people quicker than others by looking at walking patterns of people with and without knee OA. We will determine if these walking patterns and how much we walk are related to long-term progression including measures of joint damage and changes in clinical status (worsen pain, knee replacement) at a 4 to 5 year follow-up and if specific walking patterns are changed and linked to biological responses that affect both pain and joint damage after a bout of walking (30 minutes). Together this evidence will further our understanding of how to maintain knee joint health while keeping the large number of people with knee OA active and achieving overall health benefits from physical activity.