Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.
Abstract
BACKGROUND: Little is known about the relationships of circulating levels of biomarkers
of cartilage degradation with biomechanical outcomes relevant to knee osteoarthritis
(OA) or biomarker changes following non-pharmacological interventions. The objectives
of this exploratory, pilot study were to: 1) examine relationships between biomarkers
of articular cartilage degradation and synthesis with measures of knee joint load
during walking, and 2) examine changes in these biomarkers following 10 weeks of strengthening
exercises. METHODS: Seventeen (8 male, 9 female; 66.1 +/- 11.3 years of age) individuals
with radiographically-confirmed medial tibiofemoral OA participated. All participants
underwent a baseline testing session where serum and urine samples were collected,
followed by a three-dimensional motion analysis. Motion analysis was used to calculate
the external knee adduction moment (KAM) peak value and impulse. Following baseline
testing, participants were randomized to either 10 weeks of: 1) physiotherapist-supervised
lower limb muscle strengthening exercises, or 2) no exercises (control). Identical
follow-up testing was conducted 11 weeks after baseline. Biomarkers included: urinary
C-telopeptide of type II collagen (uCTX-II) and type II collagen cleavage neoepitope
(uC2C), serum cartilage oligomeric matrix protein (sCOMP), serum hyaluronic acid (sHA)
and serum C-propeptide of type II procollagen (sCPII). Linear regression analysis
was used to examine relationships between measures of the KAM and biomarker concentrations
as baseline, as well as between-group differences following the intervention. RESULTS:
KAM impulse predicted significant variation in uCTX-II levels at baseline (p = 0.04),
though not when controlling for disease severity and walking speed (p = 0.33). KAM
impulse explained significant variation in the ratio uCTX-II;sCPII even when controlling
for additional variables (p = 0.04). Following the intervention, changes in sCOMP
were significantly greater in the exercise group compared to controls (p = 0.04).
On average those in the control group experienced a slight increase in sCOMP and uCTX-II,
while those in the exercise group experienced a reduction. No other significant findings
were observed. CONCLUSIONS: This research provides initial evidence of a potential
relationship between uCTX-II and knee joint load measures in patients with medial
tibiofemoral knee OA. However, this relationship became non-significant after controlling
for disease severity and walking speed, suggesting further research is necessary.
It also appears that sCOMP is amenable to change following a strengthening intervention,
suggesting a potential beneficial role of exercise on cartilage structure. TRIAL REGISTRATION:
Clinicaltrials.gov NCT01241812.
Type
Journal articleSubject
AgedBiomarkers
Exercise Therapy
Female
Follow-Up Studies
Humans
Knee Joint
Male
Middle Aged
Osteoarthritis, Knee
Pilot Projects
Single-Blind Method
Weight-Bearing
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https://hdl.handle.net/10161/10869Published Version (Please cite this version)
10.1186/1471-2474-14-115Publication Info
Hunt, Michael A; Pollock, Courtney L; Kraus, Virginia Byers; Saxne, Tore; Peters,
Sue; Huebner, Janet L; ... Cibere, Jolanda (2013). Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise:
results from a randomized controlled pilot study. BMC Musculoskelet Disord, 14. pp. 115. 10.1186/1471-2474-14-115. Retrieved from https://hdl.handle.net/10161/10869.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Virginia Byers Kraus
Professor of Medicine
My special area of expertise is as a clinician scientist investigating osteoarthritis.
Osteoarthritis is the most common form of joint disease in man and its incidence increases
with age. It is a problem of increasing concern to the medical community due to the
increasing longevity of the population. Trained as a molecular biologist and a Rheumatologist,
I endeavor to study this disease from bedside to bench. The work in this laboratory
focuses on osteoarthritis and deals w

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