Joint Hypermobility and Lower Body Osteoarthritis

 描述（由申请人提供）：拟议项目的总体目标是确定关节过度活动对下半身骨关节炎（OA）的贡献。这项研究的结果将为临床实践提供信息，并确定需要有针对性的预防或干预方法的OA高危人群。拟议研究的基本原理是：1）关节过度活动改变了关节力学，2）关节过度活动是OA的预期独立风险因素，3）关节过度活动增加了损伤风险，这是OA的主要风险因素。 中心假设是关节过度活动与下半身OA（腰椎、髋关节、膝关节、踝关节和脚）相关，并且关节过度活动放大了其他OA风险因素的影响（即，关节损伤）。在目标1中，我们将评估横截面和纵向 关节过度活动与腰椎、髋关节和膝关节骨关节炎的流行、偶发和进展的关系。我们将通过年龄、性别和体重指数来研究这些关系，因为关节过度活动随着年龄的增长而下降，女性比男性更常见，并且随着肥胖而变化。在目标2中，我们将评估关节过度活动是否与关节损伤有关的流行、偶发和进行性腰椎、髋关节和膝关节OA。在目标3中，我们将探索关节过度活动与足部和踝关节普遍OA的横断面关系，这些关节在关节过度活动和OA的先前研究中尚未检查。为了实现这些目标，我们将进行迄今为止最大规模的研究，包括来自三项大型研究的6900多名参与者，其中包括患有和不患有OA的参与者。在所有3项研究中，对OA、损伤和关节过度活动数据进行了一致且相同的测量。多学科团队包括协作和生产力的研究人员和临床医生，他们在OA和损伤流行病学，流变学，肌肉骨骼放射学，生物力学和生物统计学方面具有专业知识。主要研究者是早期研究者、OA和损伤流行病学家以及经验丰富的物理治疗师。她是NIH/NCATS（国家推进转化科学中心）KL 2学者的最后一年，她正在开发关于OA生物力学风险因素的非药物/非手术干预的独立研究。

 DESCRIPTION (provided by applicant): The overall goal of the proposed project is to define the contribution of joint hypermobility to lower body osteoarthritis (OA). Results of this study wil inform clinical practice and determine groups at high risk for OA who require targeted prevention or intervention approaches. The rationale for the proposed research is that: 1) joint hypermobility changes joint mechanics, 2) joint hypermobility is an expected independent risk factor for OA, and 3) joint hypermobility increases the risk of injury, a major risk factor for OA. The central hypothesis is that joint hypermobility is associated with lower body OA (lumbar spine, hips, knees, ankles, and feet) and that joint hypermobility magnifies the effects of other OA risk factors (i.e., joint injury). In Aim 1, we will assess the cross-sectional and longitudinal relationships of joint hypermobility with prevalent, incident, and progressive lumbar spine, hip, and knee OA. We will examine these relationships by age, sex, and body mass index because joint hypermobility declines with age, is more common in women than men, and varies with obesity. In Aim 2, we will evaluate whether joint hypermobility interacts with joint injury with regard to prevalent, incident, and progressive lumbar spine, hip, and knee OA. In Aim 3, we will explore the cross- sectional relationship of joint hypermobility and prevalent OA at the foot and ankle, joints that have not been examined in prior studies of joint hypermobility and OA. To achieve these aims, we will conduct the largest study to date of over 6900 participants from three large studies of participants with and without OA. OA, injury, and joint hypermobility data were consistently and identically measured across all 3 studies. The multidisciplinary team includes collaborative and productive researchers and clinicians with expertise in OA and injury epidemiology, rheumatology, musculoskeletal radiology, biomechanics, and biostatistics. The Principal Investigator is an Early Stage Investigator, an OA and injury epidemiologist, and an experienced physical therapist. She is in her final year as a NIH/NCATS (National Center for Advancing Translational Sciences) KL2 Scholar in which she is developing independent research on non-pharmacologic / non- surgical interventions for biomechanical risk factors of OA.