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Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.

dc.contributor.author Hunt, Michael A
dc.contributor.author Pollock, Courtney L
dc.contributor.author Kraus, Virginia Byers
dc.contributor.author Saxne, Tore
dc.contributor.author Peters, Sue
dc.contributor.author Huebner, Janet L
dc.contributor.author Sayre, Eric C
dc.contributor.author Cibere, Jolanda
dc.coverage.spatial England
dc.date.accessioned 2015-11-10T22:34:53Z
dc.date.issued 2013-03-27
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/23530976
dc.identifier 1471-2474-14-115
dc.identifier.uri https://hdl.handle.net/10161/10869
dc.description.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.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC Musculoskelet Disord
dc.relation.isversionof 10.1186/1471-2474-14-115
dc.subject Aged
dc.subject Biomarkers
dc.subject Exercise Therapy
dc.subject Female
dc.subject Follow-Up Studies
dc.subject Humans
dc.subject Knee Joint
dc.subject Male
dc.subject Middle Aged
dc.subject Osteoarthritis, Knee
dc.subject Pilot Projects
dc.subject Single-Blind Method
dc.subject Weight-Bearing
dc.title Relationships amongst osteoarthritis biomarkers, dynamic knee joint load, and exercise: results from a randomized controlled pilot study.
dc.type Journal article
duke.contributor.id Kraus, Virginia Byers|0078823
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/23530976
pubs.begin-page 115
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Molecular Physiology Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Rheumatology and Immunology
pubs.organisational-group Orthopaedics
pubs.organisational-group Pathology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 14
dc.identifier.eissn 1471-2474
duke.contributor.orcid Kraus, Virginia Byers|0000-0001-8173-8258


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