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Mihalko SL, Messier SP. From weight loss to weight gain: utilizing the full spectrum of weight management for behavioral intervention. Osteoarthritis Cartilage 2023; 31:295-297. [PMID: 36473674 DOI: 10.1016/j.joca.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Affiliation(s)
- S L Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA; Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - S P Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA; Department of Rheumatology and Immunology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Hsieh KL, Neiberg RH, Beavers KM, Rejeski WJ, Messier SP, Nicklas BJ, Beavers DP. Effect of Baseline BMI and IL-6 Subgroup Membership on Gait Speed Response to Caloric Restriction in Older Adults with Obesity. J Nutr Health Aging 2023; 27:285-290. [PMID: 37170436 PMCID: PMC10804887 DOI: 10.1007/s12603-023-1909-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Prior work shows caloric restriction (CR) can improve physical function among older adults living with obesity. However, the contribution of starting weight and inflammatory burden to CR-associated functional improvements is unclear. The primary purpose of this study was to determine if CR-associated gait speed change varied by body mass index (BMI) and plasma interleukin 6 (IL-6) at baseline and secondarily to determine the contribution of BMI change and IL-6 change to gait speed change. DESIGN, SETTING, PARTICIPANTS Data from eight randomized control trials were pooled, with 1184 participants randomized to CR (n=661) and No CR (n=523) conditions. All studies assessed outcomes before and five or six months after assignment to CR or No CR. MEASUREMENTS BMI and IL-6 were assessed at baseline using standard procedures. Gait speed was assessed with the six-minute walk test or 400m walk test. Baseline BMI/IL-6 subgroups were constructed using BMI≥35 kg/m2 and IL-6>2.5 pg/mL thresholds. Participants with BMI≥35 kg/m2 were grouped into class 2+ obesity and BMI<35 kg/m2 into class 1- obesity; IL-6>2.5 pg/mL were grouped into high IL-6, and <2.5 pg/mL as low IL-6 (class 2+ obesity/high IL-6: n=288, class 2+ obesity/low IL-6: n=143, class 1- obesity/high IL-6: n=354, or class 1- obesity/low IL-6: n=399). All analyses used adjusted general linear models. RESULTS Gait speed significantly improved with CR versus non-CR [mean difference: +0.02 m/s (95% CI: 0.01, 0.04)]. CR assignment significantly interacted with BMI/IL-6 subgroup membership (p=0.03). Greatest gait speed improvement was observed in the class 2+ obesity/high IL-6 subgroup [+0.07 m/s (0.03, 0.10)]. No other subgroups observed significant gait speed change. For each unit decrease in BMI, gait speed change increased by +0.02 m/s (p<0.001; R2=0.26), while log IL-6 change did not significantly affect gait speed change [+0.01 m/s (p=0.20)]. CONCLUSIONS Only the class 2+ obesity/high IL-6 subgroup significantly improved gait speed in response to CR. Improvement in gait speed in this subgroup was driven by a larger decrease in BMI, but not IL-6, in response to CR. Individuals with class 2+ obesity and high IL-6 are most likely to show improved gait speed in response to CR, with improvement predominantly driven by reductions in BMI.
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Affiliation(s)
- K L Hsieh
- Katherine L. Hsieh, Department of Physical Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, USA, Phone: 336-758-3106,
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Silva GS, Sullivan JK, Katz JN, Messier SP, Hunter DJ, Losina E. Long-term clinical and economic outcomes of a short-term physical activity program in knee osteoarthritis patients. Osteoarthritis Cartilage 2020; 28:735-743. [PMID: 32169730 PMCID: PMC7357284 DOI: 10.1016/j.joca.2020.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/27/2019] [Accepted: 01/08/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Physical activity (PA) in the US knee osteoarthritis (OA) population is low, despite well-established health benefits. PA program implementation is often stymied by sustainability concerns. We sought to establish parameters that would make a short-term (3-year efficacy) PA program a cost-effective component of long-term OA care. METHOD Using a validated computer microsimulation (Osteoarthritis Policy Model), we examined the long-term clinical (e.g., comorbidities averted), quality of life (QoL), and economic impacts of a 3-year PA program, based upon the SPARKS (Studying Physical Activity Rewards after Knee Surgery) Trial, for inactive knee OA patients. We determined the cost, efficacy, and impact of PA on QoL and medical costs that would make a PA program a cost-effective addition to OA care. RESULTS Among the 14 million with knee OA in the US, >4 million are inactive. Participation of 10% in the modeled PA program could save 200 cases of cardiovascular disease, 400 cases of diabetes, and 6,800 quality-adjusted life-years (QALYs). The program had an incremental cost-effectiveness ratio (ICER) of $16,100/QALY. Tripling PA program cost ($860/year) raised the ICER to $108,300/QALY; varying QoL benefits from PA yielded ICERs of $8,800/QALY-$99,900/QALY; varying background cost savings from PA did not qualitatively impact ICERs. Offering the PA program to any adults with knee OA (not only inactive) yielded $31,000/QALY. CONCLUSION A PA program with 3-year efficacy in the knee OA population carried favorable long-term clinical and economic benefits. These results offer justification for policymakers and payers considering a PA intervention incorporated into knee OA care.
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Affiliation(s)
- G S Silva
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation EValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - J K Sullivan
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation EValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - J N Katz
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation EValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.
| | - S P Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney and Rheumatology Department, Royal North Shore Hospital, Sydney, Australia.
| | - E Losina
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation EValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
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Munugoda IP, Beavers DP, Wirth W, Aitken DA, Loeser RF, Miller GD, Lyles M, Carr JJ, Guermazi A, Hunter DJ, Messier SP, Eckstein F. The effect of weight loss on the progression of meniscal extrusion and size in knee osteoarthritis: a post-hoc analysis of the Intensive Diet and Exercise for Arthritis (IDEA) trial. Osteoarthritis Cartilage 2020; 28:410-417. [PMID: 32014493 DOI: 10.1016/j.joca.2020.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/17/2019] [Accepted: 01/08/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Weight loss has beneficial effects on clinical outcomes in knee osteoarthritis (OA), but the mechanism is still unclear. Since meniscus extrusion is associated with knee pain, this study assessed whether weight loss by diet and/or exercise is associated with less progression in meniscus extrusion measures over time. DESIGN The Intensive Diet and Exercise for Arthritis trial (IDEA) was a prospective, single-blind, randomized-controlled trial including overweight and obese older adults with knee pain and radiographic OA. Participants were randomized to 18-month interventions: exercise only, diet only or diet + exercise. In a random subsample of 105 participants, MRIs were obtained at baseline and follow-up. The medial and lateral menisci were segmented and quantitative position and size measures were obtained, along with semiquantitative extrusion measures. Linear and log-binomial regression were used to examine the association between change in weight and change in meniscus measures. Between-group differences were analyzed using an analysis of covariance. RESULTS Weight loss was associated with less progression over time of medial meniscus extrusion as measured by the maximum (β: -24.59 μm, 95%CI: -41.86, -7.33) and mean (β: -19.08 μm, 95%CI: -36.47, -1.70) extrusion distances. No relationships with weight loss were observed for lateral meniscus position, medial or lateral meniscus size or semiquantitative measures. Change in meniscus position and size did not differ significantly between groups. CONCLUSIONS Weight loss was associated with beneficial modifications of medial meniscus extrusion over 18 months. This may be one of the mechanisms by which weight loss translates into a clinical benefit. CLINICAL TRIAL REGISTRATION NCT00381290.
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Affiliation(s)
- I P Munugoda
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
| | - D P Beavers
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
| | - W Wirth
- Institute of Anatomy, Department of Imaging and Functional Muskuloskelel Research; Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany.
| | - D A Aitken
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
| | - R F Loeser
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
| | - G D Miller
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
| | - M Lyles
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
| | - J J Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - A Guermazi
- Department of Radiology, Boston University Medical School, Boston, MA, USA; Boston Imaging Core Lab (BICL), Boston, MA, USA.
| | - D J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.
| | - S P Messier
- Division of Rheumatology, Allergy and Immunology and the Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
| | - F Eckstein
- Institute of Anatomy, Department of Imaging and Functional Muskuloskelel Research; Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany.
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Runhaar J, Beavers DP, Miller GD, Nicklas BJ, Loeser RF, Bierma-Zeinstra S, Messier SP. Inflammatory cytokines mediate the effects of diet and exercise on pain and function in knee osteoarthritis independent of BMI. Osteoarthritis Cartilage 2019; 27:1118-1123. [PMID: 31009749 DOI: 10.1016/j.joca.2019.04.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/28/2019] [Accepted: 04/11/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Diet restriction and exercise form key treatments for osteoarthritis (OA) related symptoms in overweight and obese individuals. Although both interventions are known to influence systemic low-grade inflammation, which is related to pain levels and functional limitations, little is known about the potential changes in systemic inflammation as a working mechanism of diet restriction and exercise in knee OA. DESIGN Data from the Arthritis, Diet, and Activity Promotion Trial (ADAPT) were used. Through causal mediation analyses, the proportion of the effect of a 18 months diet and exercise intervention explained by the 18 months change in interleukin (IL)-6, TNF-α, soluble IL-6 receptor, soluble IL-1 receptor, CRP, and BMI were assessed, using self-reported pain and function as outcomes. RESULTS The change in inflammatory factors accounted for 15% of the total effect on pain and was totally independent of the change in BMI. The change in inflammatory factors accounted for 29% of the effect on function, with the change in BMI adding only 4% to the total mediated effect. CONCLUSIONS The change in inflammatory factors after the diet and exercise intervention was a 'medium' size mediator of the effect on pain and a 'strong' mediator for the effect on function in overweight and obese individuals with knee OA. The change in BMI added minimally to the mediated effect on function. These results highlight the relevance of changes in systemic inflammation as drivers for clinically relevant effects after diet and exercise in overweight and obese individuals with knee OA.
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Affiliation(s)
- J Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - D P Beavers
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, USA
| | - G D Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, USA
| | - B J Nicklas
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, USA
| | - R F Loeser
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, USA
| | - S Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, USA; Department of Health and Exercise Science, J. B. Snow Biomechanics Laboratory, Wake Forest University, Winston-Salem, USA
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Noehren B, Kosmac K, Walton RG, Murach KA, Lyles MF, Loeser RF, Peterson CA, Messier SP. Alterations in quadriceps muscle cellular and molecular properties in adults with moderate knee osteoarthritis. Osteoarthritis Cartilage 2018; 26:1359-1368. [PMID: 29800621 PMCID: PMC7050996 DOI: 10.1016/j.joca.2018.05.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 04/13/2018] [Accepted: 05/16/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Quadriceps muscle weakness is common in knee osteoarthritis (OA). While pain, disuse, and atrophy are commonly cited causes for muscle weakness in OA, emerging evidence suggests changes in muscle quality also occur. Alterations in muscle quality are not well understood, but likely include both cellular and morphologic adaptions. The purpose of this study was to conduct the first cellular-level analysis of the vastus lateralis in adults with moderate knee OA. METHODS Vastus lateralis biopsies were obtained from 24 subjects with moderate knee OA and 15 healthy controls. Quadriceps strength, muscle fiber cross sectional area (CSA), fiber type distribution, extracellular matrix (ECM) content, satellite cell abundance, and profibrotic gene expression were assessed. RESULTS Relative to controls, quadriceps strength was significantly lower in OA subjects (OA 62.23, 50.67-73.8 Nm vs 91.46, 75.91-107.0 Nm, P = 0.003) despite no difference in fiber CSA. OA subjects had significantly fewer Type I fibers (OA 41.51, 35.56-47.47% vs 53.07, 44.86-61.29%, P = 0.022) and more hybrid IIa/x fibers (OA 24.61, 20.61-28.61% vs 16.4, 11.60-21.20%, P = 0.009). Significantly greater ECM content, lower satellite cell density, and higher profibrotic gene expression was observed with OA, and muscle collagen content was inversely correlated to strength and satellite cell (SC) density. CONCLUSION Lower quadriceps function with moderate OA may not result from fiber size impairments, but is associated with ECM expansion. Impaired satellite cell density, high profibrotic gene expression, and a slow-to-fast fiber type transition may contribute to reduced muscle quality in OA. These findings can help guide therapeutic interventions to enhance muscle function with OA.
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Affiliation(s)
- B Noehren
- Department of Rehabilitation Sciences, College of Health Sciences, Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
| | - K Kosmac
- Department of Rehabilitation Sciences, College of Health Sciences, Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
| | - R G Walton
- Department of Rehabilitation Sciences, College of Health Sciences, Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
| | - K A Murach
- Department of Rehabilitation Sciences, College of Health Sciences, Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
| | - M F Lyles
- Section on Gerontology and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, 27109, USA.
| | - R F Loeser
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, 27599, USA.
| | - C A Peterson
- Department of Rehabilitation Sciences, College of Health Sciences, Center for Muscle Biology, University of Kentucky, Lexington, KY, 40536, USA.
| | - S P Messier
- J.B. Snow Biomechanics Laboratory, Department of Health & Exercise Science, Wake Forest University, Winston-Salem, NC, 27109, USA.
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Miller GD, Beavers DP, Hamm D, Mihalko SL, Messier SP. Nutrient Intake During Diet-Induced Weight Loss and Exercise Interventions in a Randomized Trial in Older Overweight and Obese Adults. J Nutr Health Aging 2017; 21:1216-1224. [PMID: 29188882 DOI: 10.1007/s12603-017-0892-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Dietary restriction in obese older adults undergoing weight loss may exacerbate nutrient deficiencies common in this group; the nutritional health of older adults is a factor in their quality of life, disability, and mortality. This study examined the effect of an 18-month weight loss program based in social cognitive theory incorporating partial meal replacements, on nutrient intake in older overweight and obese adults. DESIGN The following analysis is from the Intensive Diet and Exercise for Arthritis (IDEA) trial, a single-blind, randomized controlled trial. Individuals were randomized into one of three 18-month interventions: exercise (E); intensive diet-induced weight loss (D); or intensive diet-induced weight loss plus exercise (D+E). SETTING The study setting was at a university research facility. PARTICIPANTS Overweight and obese older adults (n=388; BMI=33.7±3.8 kg/m2; 65.8±6.1 years) were recruited. INTERVENTIONS The D and D+E interventions (group mean goal of ≥10% loss by 18-months) utilized partial meal replacements (2 meal replacement shakes/day for 6-months). Exercise training for E and D+E was 3 days/week, 60 minutes/day. MEASUREMENTS Three day food records were collected at baseline, 6-months, and 18-months and analyzed for total energy and macro- and micronutrient intake. Comparisons of dietary intake among treatment groups were performed at 6 and 18 months using mixed linear models. RESULTS Weight loss at 18-months was 11.3±8.3% (D), 10.3±6.8% (D+E), and 1.2±4.2% (E). Meal replacements were used by more than 60% (6-months) and 50% (18-months) of D and D+E participants, compared to ≤15% for E. Both D and D+E consumed less energy and fat, and more carbohydrates and selected micronutrients than E during follow-up. More than 50% of all participants consumed less than the recommended intake of particular vitamins and minerals. CONCLUSIONS The diet intervention improved intakes of several nutrients. However, inadequate intake of several vitamins and minerals of concern for older adults suggests they need further guidance to assure adequate intake.
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Affiliation(s)
- G D Miller
- Gary D. Miller, PhD, Box 7868 Reynolda Station, Department Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109-7868, ; 336-758-1901; 336-758-4680 (fax)
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Messier SP, Callahan LF, Golightly YM, Keefe FJ. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis. Osteoarthritis Cartilage 2015; 23:787-97. [PMID: 25952349 DOI: 10.1016/j.joca.2015.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/06/2015] [Accepted: 03/09/2015] [Indexed: 02/02/2023]
Abstract
The objective was to develop a set of "best practices" for use as a primer for those interested in entering the clinical trials field for lifestyle diet and/or exercise interventions in osteoarthritis (OA), and as a set of recommendations for experienced clinical trials investigators. A subcommittee of the non-pharmacologic therapies committee of the OARSI Clinical Trials Working Group was selected by the Steering Committee to develop a set of recommended principles for non-pharmacologic diet/exercise OA randomized clinical trials. Topics were identified for inclusion by co-authors and reviewed by the subcommittee. Resources included authors' expert opinions, traditional search methods including MEDLINE (via PubMed), and previously published guidelines. Suggested steps and considerations for study methods (e.g., recruitment and enrollment of participants, study design, intervention and assessment methods) were recommended. The recommendations set forth in this paper provide a guide from which a research group can design a lifestyle diet/exercise randomized clinical trial in patients with OA.
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Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA; Department of Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - L F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Y M Golightly
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - F J Keefe
- Department of Psychiatry, Duke University, Durham, NC, USA
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Messier SP. Weight gain and incident knee osteoarthritis in asymptomatic at risk patients: a step closer to primary prevention trials. Osteoarthritis Cartilage 2015; 23:501-2. [PMID: 25576878 DOI: 10.1016/j.joca.2014.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 12/30/2014] [Indexed: 02/02/2023]
Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA; Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA; Section on Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Beavers KM, Beavers DP, Newman JJ, Anderson AM, Loeser RF, Nicklas BJ, Lyles MF, Miller GD, Mihalko SL, Messier SP. Effects of total and regional fat loss on plasma CRP and IL-6 in overweight and obese, older adults with knee osteoarthritis. Osteoarthritis Cartilage 2015; 23:249-56. [PMID: 25450847 PMCID: PMC4304884 DOI: 10.1016/j.joca.2014.11.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/13/2014] [Accepted: 11/01/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe associations between total and regional body fat mass loss and reduction of systemic levels of inflammation (C-reactive protein (CRP) and interleukin-6 (IL-6)) in obese, older adults with osteoarthritis (OA), undergoing intentional weight loss. DESIGN Data come from a single-blind, 18-month, randomized controlled trial in adults (age: 65.6 ± 6.2; Body mass index (BMI): 33.6 ± 3.7) with knee OA. Participants were randomized to diet-induced weight loss plus exercise (D + E; n = 150), diet-induced weight loss-only (D; n = 149), or exercise-only (E; n = 151). Total body and region-specific (abdomen and thigh) fat mass were measured at baseline and 18 months. High-sensitivity CRP and IL-6 were measured at baseline, six and 18 months. Intervention effects were assessed using mixed models and associations between inflammation and adiposity were compared using logistic and mixed linear regression models. RESULTS Intentional total body fat mass reduction was associated with significant reductions in log-adjusted CRP (β = 0.06 (95% CI = 0.04, 0.08) mg/L) and IL-6 (β = 0.02 (95% CI = 0.01, 0.04) pg/mL). Loss of abdominal fat volume was also associated with reduced inflammation, independent of total body fat mass; although models containing measures of total adiposity yielded the best fit. The odds of achieving clinically desirable levels of CRP (<3.0 mg/L) and IL-6 (<2.5 pg/mL) were 3.8 (95% CI = 1.6, 8.9) and 2.2 (95% CI = 1.1, 4.6), respectively, with 5% total weight and fat mass loss. CONCLUSIONS Achievement of clinically desirable levels of CRP and IL-6 more than double with intentional 5% loss of total body weight and fat mass. Global, rather than regional, measures of adiposity are better predictors of change in inflammatory burden. CLINICAL TRIAL REGISTRATION NUMBER NCT00381290.
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Affiliation(s)
- K M Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - D P Beavers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - J J Newman
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - A M Anderson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - R F Loeser
- Division of Rheumatology, Allergy, and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
| | - B J Nicklas
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - M F Lyles
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - G D Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - S L Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
| | - S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
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Henriksen M, Hunter DJ, Dam EB, Messier SP, Andriacchi TP, Lohmander LS, Aaboe J, Boesen M, Gudbergsen H, Bliddal H, Christensen R. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial. Osteoarthritis Cartilage 2013; 21:1865-75. [PMID: 24135273 DOI: 10.1016/j.joca.2013.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 08/13/2013] [Accepted: 10/04/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). METHODS Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. RESULTS 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. CONCLUSION For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. CLINICALTRIALSGOV NCT00655941.
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Affiliation(s)
- M Henriksen
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Copenhagen F, Denmark
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12
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Miller GD, Nicklas BJ, Davis CC, Legault C, Messier SP. Basal growth hormone concentration increased following a weight loss focused dietary intervention in older overweight and obese women. J Nutr Health Aging 2012; 16:169-74. [PMID: 22323353 DOI: 10.1007/s12603-011-0152-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Growth and sex steroid hormones decrease with aging and obesity. The effect of dietary weight loss and exercise training lifestyle interventions was examined on hormones as well as determining their relationships with physical function in older obese and overweight adults. DESIGN Individuals were randomized into one of four 18 month interventions: Healthy Lifestyle (HL), Exercise, Diet, and Exercise-Diet. SETTING Clinical research setting with facility based exercise and nutrition education and behavior classrooms. PARTICIPANTS Older (≥60 yrs) overweight and obese (BMI≥28 kg/m(2)) adults with knee osteoarthritis (n=309) were recruited for the study. INTERVENTION Weight loss goal for Diet groups was ≥5%. Exercise groups trained (mostly walking and resistance training) 3 days/week for 60 min/session. MEASUREMENTS Body weight, growth hormone (GH), corticosterone, sex-hormone binding globulin (SHBG), testosterone, and dehydroepiandrosterone (DHEA) were measured at baseline, 6, and 18 months. Physical function was determined through performance task (6-min walking distance) and self-reported questionnaires (Western Ontario McMaster University Osteoarthritis Index-WOMAC) at similar time points. RESULTS Diet, Exercise, and Exercise-Diet groups lost 4.9%, 3.5%, and 6.2% of their weight at 18 months, respectively. There was a significant diet treatment effect on GH levels in women as higher concentrations of this hormone were apparent following dietary weight loss intervention (p=0.01). No other hormones were affected by either diet or exercise treatments in men or women. A significant inverse correlation between baseline 6-minute walking distance and SHBG (r=-0.33) was found in men. CONCLUSION The increase in basal GH levels from the diet treatment in women suggests that this lifestyle behavior intervention may mitigate the age- and obesity-related decreases in growth hormone levels, to help preserve muscle mass, strength, and physical function in older adults.
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Affiliation(s)
- G D Miller
- Department Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109-7868, USA.
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Aaboe J, Bliddal H, Messier SP, Alkjær T, Henriksen M. Effects of an intensive weight loss program on knee joint loading in obese adults with knee osteoarthritis. Osteoarthritis Cartilage 2011; 19:822-8. [PMID: 21440076 DOI: 10.1016/j.joca.2011.03.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 03/16/2011] [Accepted: 03/17/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA). METHODS Participants included 157 obese knee OA patients that underwent a 16-week dietary intervention. Three-dimensional gait analyses were performed before and after the intervention at the participants' freely chosen walking speed. Knee joint compression forces, axial impulses, knee flexion angle and frontal and sagittal plane knee moments were calculated to determine the biomechanical effects of the weight loss. RESULTS 157 subjects (89% of the initial cohort) completed the 16-week intervention. The average weight loss of 13.7 kg (P<.0001) corresponded to 13.5% of the baseline body weight. The weight loss resulted in a 7% reduction in knee joint loading, a 13% lower axial impulse, and a 12% reduction in the internal knee abductor moment (KAM). There were no clear effects on sagittal plane knee moments or peak knee flexion angle. Linear regression analyses adjusted for changes in walking speed showed that for every 1 kg in weight loss, the peak knee load was reduced by 2.2 kg. Thus, every kilo reduction in body weight was related to more than twice the reduction in peak knee force at a given walking speed. CONCLUSION Weight loss is an excellent short-term investment in terms of joint loading for patients with combined obesity and knee OA. The effects of sustained weight loss on disease progression and symptoms in relation to biomechanical factors remain to be shown.
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Affiliation(s)
- J Aaboe
- Clinical Motor Function Laboratory, Parker Institute, Copenhagen University Hospital-Frederiksberg, Frederiksberg, Denmark.
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14
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Messier SP, Mihalko S, Loeser RF, Legault C, Jolla J, Pfruender J, Prosser B, Adrian A, Williamson JD. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthritis Cartilage 2007; 15:1256-66. [PMID: 17561418 DOI: 10.1016/j.joca.2007.04.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2006] [Accepted: 04/09/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This preliminary study sought to determine whether using 1500/1200mg of glucosamine hydrochloride and chondroitin sulfate (GH/CS) is effective, both separately and combined with exercise, compared to a placebo plus exercise program in improving physical function, pain, strength, balance, and mobility in older adults with knee osteoarthritis (OA). METHODS This double-blind, placebo-controlled, randomized clinical trial lasted 12 months. Participants included 89 older adults (age>/=50 years) with knee OA randomized to either GH/CS or placebo group. Phase I was a 6-month trial comparing the effects of assignment to either GH/CS or placebo. Phase II added 6 months of exercise for both groups. The primary outcome measure was Western Ontario and McMaster University Osteoarthritis Index (WOMAC) function, and secondary outcome measures included WOMAC pain, 6-min walk, balance, and knee strength. RESULTS Of the 89 randomized participants, 72 (81%) completed the study. The median pill compliance was 94% and 95% in Phase I, and, in Phase II, 97% and 91% for the GH/CS and placebo groups, respectively. Median exercise compliance during Phase II was 77% for the GH/CS group and 78% for the placebo group. WOMAC function and pain did not differ significantly between the groups at 6- or 12-month follow-up. There were also no significant differences between the groups in 6-min walk or knee strength; however, balance was better in the placebo group with approximately a 10% difference compared to the GH/CS group. CONCLUSIONS The GH/CS group was not superior to the placebo group in function, pain, or mobility after both phases of the intervention (pill only and pill plus exercise).
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Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, United States.
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Brenes GA, Williamson JD, Messier SP, Rejeski WJ, Pahor M, Ip E, Penninx BWJH. Treatment of minor depression in older adults: a pilot study comparing sertraline and exercise. Aging Ment Health 2007; 11:61-8. [PMID: 17164159 PMCID: PMC2885010 DOI: 10.1080/13607860600736372] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to conduct a pilot clinical trial to test the feasibility and efficacy of an exercise program and anti-depressant treatment compared with usual care in improving the emotional and physical functioning of older adults with minor depression. Participants were 37 older adults with minor depression who were randomized to exercise, sertraline, or usual care; 32 participants completed the 16-week study. Outcomes included measures of both emotional (clinician and self-report) and physical (observed and self-report) functioning. There were trends for the superiority of the exercise and sertraline conditions over usual care in improving SF-36 mental health scores and clinician-rated depression scores. Individuals in the exercise condition showed greater improvements in physical functioning than individuals in the usual care condition. Both sertraline and exercise show promise as treatments for late-life minor depression. However, exercise has the added benefit of improving physical functioning as well.
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Affiliation(s)
- G A Brenes
- Department of Social Sciences and Health Policy, Winston-Salem, NC 25157, USA.
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Miller GD, Nicklas BJ, Davis CC, Ambrosius WT, Loeser RF, Messier SP. Is serum leptin related to physical function and is it modifiable through weight loss and exercise in older adults with knee osteoarthritis? Int J Obes (Lond) 2004; 28:1383-90. [PMID: 15278105 DOI: 10.1038/sj.ijo.0802737] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effect of weight loss and exercise interventions on serum leptin and to investigate the relationship of physical function and osteoarthritis (OA) severity with serum leptin in older overweight and obese adults with knee OA. In addition, the study examined if serum leptin predicts weight loss. DESIGN Longitudinal, controlled clinical trial of weight loss and exercise interventions. SUBJECTS Community dwelling, older, overweight and obese adults (n=316; >60 years of age; body mass index >/=28.0 kg m(-2)) with symptomatic knee OA and self-reported difficulty in performing selected physical activities were recruited. INTERVENTIONS Participants were randomized into one of four groups for the 18-month study duration: Healthy Lifestyle Controls, Dietary Weight Loss (Diet), Exercise Training (Exercise), and a combination of Dietary Weight Loss and Exercise Training (Diet+Exercise). The weight loss goal for the two Diet groups was 5% from baseline at 18 months. Participants in the Exercise groups were trained for 3 days week(-1), 60 min day(-1). MEASUREMENTS Body weight, body mass index, serum leptin, physical function, and OA severity were measured at baseline, 6 months, and 18 months. RESULTS Diet and Diet+Exercise groups lost 5.3 and 6.1% of their weight, respectively, at 18 months with the Exercise group losing 2.9%. There was a significant main effect of weight loss on serum leptin with a decrease in serum leptin averaged across the 6- and 18-month time points for the Diet and Diet+Exercise groups compared to the other two groups (beta=0.245; P<0.01). No main effect for exercise training was observed. Serum leptin was related to self-reported physical function. In all participants, a mixed model analysis demonstrated that lower levels of baseline serum leptin predict larger weight loss (beta=-2.779; P=0.048). CONCLUSION Decreases in serum leptin may be one mechanism by which weight loss improves physical function and symptoms in OA patients.
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Affiliation(s)
- G D Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA.
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Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med 2001; 161:2309-16. [PMID: 11606146 DOI: 10.1001/archinte.161.19.2309] [Citation(s) in RCA: 219] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The prevention of disability in activities of daily living (ADL) may prolong older persons' autonomy (older persons are defined in this study as those aged > or =60 years). However, proved preventive strategies for ADL disability are lacking. A sedentary lifestyle is an important cause of disability. This study examines whether an exercise program can prevent ADL disability. METHODS A 2-center, randomized, single-blind, controlled trial was conducted in which participants were assigned to an aerobic exercise program, a resistance exercise program, or an attention control group. Of the 439 community-dwelling persons aged 60 years or older with knee osteoarthritis originally recruited, the 250 participants initially free of ADL disability were used for this study. Incident ADL disability, defined as developing difficulty in transferring from a bed to a chair, eating, dressing, using the toilet, or bathing, was assessed quarterly during 18 months of follow-up. RESULTS The cumulative incidence of ADL disability was lower in the exercise groups (37.1%) than in the attention control group (52.5%) (P =.02). After adjustment for demographics and baseline physical function, the relative risk of incident ADL disability for assignment to exercise was 0.57 (95% confidence interval, 0.38-0.85; P =.006). Both exercise programs prevented ADL disability; the relative risks were 0.60 (95% confidence interval, 0.38-0.97; P =.04) for resistance exercise and 0.53 (95% confidence interval, 0.33-0.85; P =.009) for aerobic exercise. The lowest ADL disability risks were found for participants with the highest compliance to exercise. CONCLUSIONS Aerobic and resistance exercise may reduce the incidence of ADL disability in older persons with knee osteoarthritis. Exercise may be an effective strategy for preventing ADL disability and, consequently, may prolong older persons' autonomy.
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Affiliation(s)
- B W Penninx
- Sticht Center on Aging, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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Miller ME, Rejeski WJ, Messier SP, Loeser RF. Modifiers of change in physical functioning in older adults with knee pain: the Observational Arthritis Study in Seniors (OASIS). Arthritis Rheum 2001; 45:331-9. [PMID: 11501720 DOI: 10.1002/1529-0131(200108)45:4<331::aid-art345>3.0.co;2-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To ascertain predictors of decline in physical functioning among older adults reporting knee pain. METHODS The Observational Arthritis Study in Seniors was a longitudinal study of 480 adults over 65 years of age. Measurements of strength, sociodemographic characteristics, disease burden (including radiographic knee osteoarthritis [OA]), self-reported disability, and functional limitations were obtained on participants at baseline and at 15 and 30 months. RESULTS Radiographic evidence of OA at baseline was moderately associated with an increased decline in both transfer (P = 0.06) and ambulatory-based performance tasks (P = 0.04) but not in self-reported disability. This effect disappeared after accounting for baseline levels of knee pain intensity and knee strength. CONCLUSION Knee pain intensity and knee strength may mediate the relationship between radiographic evidence of knee OA and change in performance. Although it is not clear whether joint disease precedes or follows a decline in muscular strength, these results may help to identify subpopulations of older persons with knee OA who may benefit from interventions aimed at slowing the progression of disability related to transfer and ambulatory-based tasks.
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Affiliation(s)
- M E Miller
- Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA
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Jadelis K, Miller ME, Ettinger WH, Messier SP. Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis). J Am Geriatr Soc 2001; 49:884-91. [PMID: 11527479 DOI: 10.1046/j.1532-5415.2001.49178.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the relationship between muscular strength and dynamic balance in a sample of older adults with knee pain and to determine the role that obesity and severity of knee pain play in the ability to maintain balance. DESIGN Cross-sectional study designed to examine the association between strength and balance in a cohort of older adults with chronic knee pain. SETTING A university health and exercise science center. PARTICIPANTS A cohort of 480 adults age 65 and older with knee pain. MEASUREMENTS Force platform dynamic balance measure of the center of pressure excursion during a forward and subsequent backward lean. Isokinetic strength measures of concentric and eccentric knee flexion and extension and concentric ankle plantar flexion and dorsiflexion. Body mass index (BMI) and a knee pain scale were used to measure obesity and knee pain, respectively. RESULTS A regression model was developed to investigate the relationship between dynamic balance and muscular strength while controlling for gender, BMI, radiographic severity, knee pain, and foot length. Knee strength alone explained 18.4% of the variability in dynamic balance. The addition of knee pain, BMI, radiographic severity, gender, and foot length explained an additional 6.7%. When the knee-ankle interaction, ankle strength, and knee strength--pain interaction variables were added to the regression model, 28.9% of the variability in dynamic balance was explained. CONCLUSIONS Strength appears to play a significant role in maintaining balance in an older, osteoarthritic population. We found that mean knee strength accounted for approximately 19% of the variability in dynamic balance. Hence, greater knee strength was associated with better dynamic balance. The best dynamic balance performances occurred in participants that had a combination of strong knees and strong ankles. However, knee osteoarthritic patients with weak knee strength could still maintain high levels of dynamic balance by having strong ankle strength. Moreover, we have shown that obesity is associated with attenuated dynamic balance performance and that poorer balance is associated with higher pain scores in the presence of weaker knees. For stronger knees, however, pain does not appear to be related to balance.
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Affiliation(s)
- K Jadelis
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27109, USA
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Abstract
PURPOSE The objectives of this study were 1) to examine the differences between a noninjured (C) cohort of runners (N = 70) and runners afflicted with anterior knee pain (AKP) according to selected training, anthropometric, rearfoot motion, ground reaction force, and muscular strength and endurance variables; 2) to explore multivariate relationships among these measures in the well and injured groups; and 3) to develop specific hypotheses concerning risk factors for injury that will later be tested in a prospective clinical study. METHODS High speed videography (200 frames x s(-1)), a force platform (500 Hz), and a Cybex II+ isokinetic dynamometer were used to assess rearfoot motion, ground reaction forces, and knee muscular strength and endurance, respectively. A linear discriminant function was performed on each of the five categories of variables and revealed 19 significant (P < or = 0.05) predictors. These variables were then combined and a final discriminant function analysis was performed. RESULTS Pronation through the first 10% of stance, arch index, shoe mileage, and extension peak torque were the best overall (P < or = 0.05) predictors. The AKP group had smaller mean values on all four significant predictors. CONCLUSION With the exception of shoe mileage, which is likely a response to rather than a risk factor for AKP, these results should prove useful to clinicians in identifying runners at risk for anterior knee pain.
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Affiliation(s)
- M J Duffey
- Department of Health and Exercise Science, Wake Forest University, Winston- Salem, NC 27109, USA
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Messier SP, Loeser RF, Mitchell MN, Valle G, Morgan TP, Rejeski WJ, Ettinger WH. Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study. J Am Geriatr Soc 2000; 48:1062-72. [PMID: 10983905 DOI: 10.1111/j.1532-5415.2000.tb04781.x] [Citation(s) in RCA: 213] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purposes of this pilot study were to determine if a combined dietary and exercise intervention would result in significant weight loss in older obese adults with knee osteoarthritis, and to compare the effects of exercise plus dietary therapy with exercise alone on gait, strength, knee pain, biomarkers of cartilage degradation, and physical function. DESIGN Single-blind, two-arm, randomized clinical trial conducted for 24 weeks. SETTING A university health and exercise science center. PARTICIPANTS Twenty-four community-dwelling obese older adults aged > or = 60 years, body mass index > or = 28, knee pain, radiographic evidence of knee osteoarthritis, and self-reported physical disability. INTERVENTION Randomization into two groups: exercise and diet (E&D) and exercise alone (E). Exercise consisted of a combined weight training and walking program for 1 hour three times per week. The dietary intervention included weekly sessions with a nutritionist utilizing cognitive-behavior modification to change dietary habits to reach a group goal of an average weight loss of 15 lb (6.8 kg) over 6 months. MEASUREMENTS All measurements were conducted at baseline and 3 and 6 months, except for synovial fluid analysis, which was obtained only at baseline and 6 months. In addition, weight was measured weekly in the E&D group. Physical disability and knee pain were measured by self-report and physical performance was measured using the 6-minute walk and stair climb tasks. Biomechanical testing included kinetic and kinematic analysis of gait and isokinetic strength testing. Synovial fluid was analyzed for levels of total proteoglycan, keratan sulfate, and interleukin-1 beta. RESULTS Twenty-one of the 24 participants completed the study, with one dropout in the E&D group and two in the E group. The E&D group lost a mean of 18.8 lb (8.5 kg) at 6 months compared with 4.0 lb (1.8 kg) in the E group (P = .01). Significant improvements were noted in both groups in self-reported disability and knee pain intensity and frequency as well as in physical performance measures. However, no statistical differences were found between the two groups at 6 months in knee pain scores or self-reported performance measures of physical function. There was no difference in knee strength between the groups, with both groups showing modest improvements from baseline to 6 months. At 6 months, the E&D group had a significantly greater loading rate (P = .03) and maximum braking force (P = .01) during gait. There were no significant between-group differences in the other biomechanical measures. Synovial fluid samples were obtainable at both baseline and 6 months in eight participants (four per group). The level of keratan sulfate decreased similarly in both groups from an average baseline of 96.8 +/- 37.1 to 71.5 +/- 23 ng/microg total proteoglycan. The level of IL-1 decreased from 25.3 +/- 9.8 at baseline to 8.3 +/- 6.1 pg/mL. The decrease in IL-1 correlated with the change in pain frequency (r = -0.77, P = .043). CONCLUSIONS Weight loss can be achieved and sustained over a 6-month period in a cohort of older obese persons with osteoarthritis of the knee through a dietary and exercise intervention. Both exercise and combined weight loss and exercise regimens lead to improvements in pain, disability, and performance. Moreover, the trends in the biomechanical data suggest that exercise combined with diet may have an additional benefit in improved gait compared with exercise alone. A larger study is indicated to determine if weight loss provides additional benefits to exercise alone in this patient population.
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Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA
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Messier SP, Royer TD, Craven TE, O'Toole ML, Burns R, Ettinger WH. Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST). J Am Geriatr Soc 2000; 48:131-8. [PMID: 10682941 DOI: 10.1111/j.1532-5415.2000.tb03903.x] [Citation(s) in RCA: 152] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the effects of 18-month aerobic walking and strength training programs on static postural stability among older adults with knee osteoarthritis. DESIGN Randomized, single-blind, clinical trial of therapeutic exercise. SETTING Both center-based (university) and home-based. PARTICIPANTS A cohort of 103 older adults (age = 60 years) with knee osteoarthritis who were participants in a large (n = 439) clinical trial and who were randomly assigned to undergo biomechanical testing. INTERVENTION An 18-month center- (3 months) and home-based (15 months) therapeutic exercise program. The subjects were randomized to one of three treatment arms: (1) aerobic walking; (2) health education control; or (3) weight training. MEASUREMENTS Force platform static balance measures of average length (Rm) of the center of pressure (COP), average velocity (Vel) of the COP, elliptical area (Ae) of the COP, and balance time (T). Measures were made under four conditions: eyes open, double- and single-leg stances and eyes closed, double- and single-leg stances. RESULTS In the eyes closed, double-leg stance condition, both the aerobic and weight training groups demonstrated significantly better sway measures relative to the health education group. The aerobic group also demonstrated better balance in the eyes open, single-leg stance condition. CONCLUSIONS Our results suggest that long-term weight training and aerobic walking programs significantly improve postural sway in older, osteoarthritic adults, thereby decreasing the likelihood of larger postural sway disturbances relative to a control group.
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Affiliation(s)
- S P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA
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McCrory JL, Martin DF, Lowery RB, Cannon DW, Curl WW, Read HM, Hunter DM, Craven T, Messier SP. Etiologic factors associated with Achilles tendinitis in runners. Med Sci Sports Exerc 1999; 31:1374-81. [PMID: 10527307 DOI: 10.1097/00005768-199910000-00003] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to determine whether relationships exist between selected training, anthropometric, isokinetic muscular strength, and endurance, ground reaction force, and rearfoot movement variables in runners afflicted with Achilles tendinitis. METHODS Specifically, we examined differences in selected measures between a noninjured cohort of runners (N = 58) and a cohort of injured runners with Achilles tendinitis (N = 31). Isokinetic, kinetic, and kinematic measures were collected using a Cybex II+ isokinetic dynamometer (Medway, MA), AMTI force plate (500 Hz), and Motion Analysis high-speed videography (200 Hz), respectively. Separate discriminant function analyses were performed on each of the five sets of variables to identify the factors that best discriminate between the injured and control groups. RESULTS Years running, training pace, stretching habits (injured runners were less likely to incorporate stretching into their training routine), touchdown angle, plantar flexion peak torque at 180 degrees x s(-1) and arch index were found to be significant discriminators. CONCLUSION A combined discriminant analysis using the above mentioned significant variables revealed that plantar flexion peak torque, touchdown angle, and years running were the strongest discriminators between runners afflicted with Achilles tendinitis and runners who had no history of overuse injury.
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Affiliation(s)
- J L McCrory
- Department of Health and Exercise Science, Wake Forest University, Winston- Salem, NC 27109, USA
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Abstract
PURPOSE To examine the validity of the Physical Activity Scale for the Elderly (PASE) among individuals with disability. METHODS A sample of 471 participants (mean age = 71.36) in an epidemiological study of chronic knee pain completed the PASE and self-report measures of knee pain, perceived physical function, satisfaction with physical function, and importance of physical function. A 6-min walk test and an isokinetic assessment of knee strength were also administered. RESULTS PASE scores were significantly correlated in expected directions with performance on the 6-min walk, knee strength, frequency of knee pain during transfer, and perceived difficulty with physical functioning. Gender and age were identified as significant moderators of PASE scores and the scale's construct validity was supported by testing a conceptually driven hypothesis regarding patterns of physical activity. CONCLUSIONS These results support the PASE's validity for the assessment of physical activity among older adults with pain and disability.
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Affiliation(s)
- K A Martin
- Department of Health and Exercise Science and the Wake Forest University School of Medicine, Wake Forest University, Winston-Salem, NC 27109, USA
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Ettinger WH, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, Shumaker S, Berry MJ, O'Toole M, Monu J, Craven T. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997; 277:25-31. [PMID: 8980206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. SETTING AND DESIGN A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. PARTICIPANTS A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. INTERVENTIONS An aerobic exercise program, a resistance exercise program, and a health education program. MAIN OUTCOME MEASURES The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x-ray score, aerobic capacity, and knee muscle strength. RESULTS A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (+/- SE) score on the physical disability questionnaire (1.71 +/- 0.03 vs 1.90 +/- 0.04 units; P<.001), a 12% lower score on the knee pain questionnaire (2.1 +/- 0.05 vs 2.4 +/- 0.05 units; P=.001), and performed better (mean [+/- SE]) on the 6-minute walk test (1507 +/- 16 vs 1349 +/- 16 ft; P<.001), mean (+/-SE) time to climb and descend stairs (12.7 +/- 0.4 vs 13.9 +/- 0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1 +/- 0.2 vs 10.0 +/- 0.1 seconds; P<.001), and mean (+/-SE) time to get in and out of a car (8.7 +/- 0.3 vs 10.6 +/- 0.3 seconds; P<.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74 +/- 0.04 vs 1.90 +/- 0.03 units; P=.003), 8% lower pain score (2.2 +/- 0.06 vs 2.4 +/- 0.05 units; P=.02), greater distance on the 6-minute walk (1406 +/- 17 vs 1349 +/- 16 ft; P=.02), faster times on the lifting and carrying task (9.3 +/- 0.1 vs 10.0 +/- 0.16 seconds; P=.001), and the car task (9.0 +/- 0.3 vs 10.6 +/- 0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. CONCLUSIONS Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.
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Affiliation(s)
- W H Ettinger
- Department of Internal Medicine, Bowman Gray School of Medicine, Winston-Salem, NC, USA
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Martin PE, Grabiner MD, Collins JJ, Messier SP, Ashton-Miller JA. POSTURAL CONTROL AND GAIT DEFICIENCIES IN ELDERLY ADULTS 892. Med Sci Sports Exerc 1996. [DOI: 10.1097/00005768-199605001-00890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Messier SP, Edwards DG, Martin DF, Lowery RB, Cannon DW, James MK, Curl WW, Read HM, Hunter DM. Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc 1995; 27:951-60. [PMID: 7564981 DOI: 10.1249/00005768-199507000-00002] [Citation(s) in RCA: 105] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The objectives of our study were: 1) to examine differences between a noninjured cohort of runners (N = 70) and runners afflicted with iliotibial band friction syndrome (ITBFS) (N = 56) according to selected anthropometric, biomechanical, muscular strength, and training measures; 2) to explore multivariate relationships among these measures in both the well and injured groups; and 3) to develop specific hypotheses concerning risk factors for injury that will later be tested in a prospective observational study. High speed videography (200 fps), a force platform (500 Hz), and a Cybex II+ isokinetic dynamometer were used to assess rearfoot motion, ground reaction forces, and knee muscular strength and endurance, respectively. A linear discriminant function analysis of the training data revealed weekly mileage, training pace, number of months using current training protocol, % time spent swimming, and % time spent running on a track to be significant (P < 0.10). Height was a significant anthropometric discriminator, while seven isokinetic strength and endurance measures were found to discriminate significantly between the groups. Calcaneal to vertical touchdown angle, and maximum supination velocity were significant rearfoot movement discriminators. Maximum braking force was the only significant kinetic discriminator. A combined discriminant analysis using those variables found to be significant in the previous analyses revealed weekly mileage, and maximum normalized braking force to be the best discriminators (model P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Wake Forest University, Winston-Salem, NC 27109, USA
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Messier SP, Ettinger WH, Doyle TE, Morgan T, James MK, OʼToole ML, Bums R, Snow JB. OBESITY: EFFECTS ON GAIT IN AN OSTEOARTHRITIC POPULATION. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-00240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Messier SP. Osteoarthritis of the knee and associated factors of age and obesity: effects on gait. Med Sci Sports Exerc 1994; 26:1446-52. [PMID: 7869877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
1) A majority of people afflicted with osteoarthritis (OA) of the knee are elderly and many have their OA exacerbated by obesity. 2) Healthy older adults exhibit gait patterns that differ from a healthy, younger cohort. These differences include a slower walking velocity, slower cadence, shorter step length, reduced hip and knee range of motion, and greater stride width, vertical oscillation, and lateral sway of the head. 3) Subjects afflicted with knee OA have decreased knee range of motion and knee angular velocity, increased loading rate on the less affected leg, and a compensatory increase in hip angular velocity when compared with age matched healthy subjects. 4) Obesity, which is strongly associated with knee OA, increases rearfoot motion during walking and causes the forefoot to abduct significantly more than in normal weight individuals.
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health & Sport Science, Wake Forest University, Winston-Salem, NC 27109
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Messier SP. Osteoarthritis of the knee: an interdisciplinary perspective. Med Sci Sports Exerc 1994; 26:1427-8. [PMID: 7869873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health & Sport Science, Wake Forest University, Winston-Salem, NC 27109
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31
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Messier SP, Edwards DG, Martin DF, Lowery RB, Cannon DW, Craven T, Curl WW, Read HM, Hunter DM. 5 ETIOLOGY OF ILIOTIBIAL BAND FRICTION SYNDROME (ITBFS) IN DISTANCE RUNNERS. Med Sci Sports Exerc 1994. [DOI: 10.1249/00005768-199405001-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
The purpose of our study was to determine the effects of severe obesity on the foot mechanics of adult females. Twenty-nine adult females between the ages of 20 and 48 years volunteered as subjects for this investigation. The subjects were separated into a severely obese (O) group (body mass index = 41.14 +/- 2.61; N = 16) and a normal weight control group (body mass index = 20.84 +/- 0.47; N = 13). A Locam camera (100 Hz) positioned perpendicular to the subjects' posterior aspect was used to film the rearfoot movement of the subjects during the final 15 sec of a 10 min treadmill walk. The O group had a significantly greater touchdown angle (P = .05), more total eversion range of motion (P = .001), and a faster maximum eversion velocity (P < .001). Moreover, analysis of dynamic foot angles indicated that the O group had significantly (P = .003) more forefoot abduction. Finally, anthropometric data revealed statistically different (P < .001) Q angle measurements between the O and control groups. The results of this study suggest that severely obese females have significantly greater rearfoot motion, foot angle, and Q angle values than normal weight females.
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Wake Forest University, Winston-Salem, North Carolina 27109
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Messier SP, Loeser RF, Hoover JL, Semble EL, Wise CM. Osteoarthritis of the knee: effects on gait, strength, and flexibility. Arch Phys Med Rehabil 1992; 73:29-36. [PMID: 1729969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study examined the differences in gait mechanics, isokinetic knee strength, and flexibility between a group of adults with symptomatic osteoarthritis (OA) of the knee (n = 15) and an age-, mass-, and gender-matched group of control subjects (n = 15). Both groups performed under similar environmental conditions. Our results suggest that patients with symptomatic OA of the knee have poorer flexibility in both the affected and unaffected legs and demonstrate significantly less (p less than .05) knee angular velocity and, to a lesser extent, knee range of motion during gait. They have an increased loading rate in the unaffected leg after heel strike, exert less peak vertical force during pushoff, and are significantly weaker in both the dominant and nondominant legs compared to adults with no lower extremity disease.
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Affiliation(s)
- S P Messier
- Department of Health and Sport Science, Wake Forest University, Winston-Salem, NC 27109
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Messier SP, Davis SE, Curl WW, Lowery RB, Pack RJ. Etiologic factors associated with patellofemoral pain in runners. Med Sci Sports Exerc 1991; 23:1008-15. [PMID: 1943620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to extend our knowledge of running related injuries by determining whether relationships exist between selected anthropometric, biomechanical, muscular strength and endurance, and training variables and runners afflicted with patellofemoral pain (PFP). Specifically, the objectives of this study were to examine differences in selected measures between a non-injured control group (C) of runners (N = 20) and a group of injured runners (INJ) diagnosed by an orthopedic surgeon as having PFP (N = 16). High speed photography, a force platform, and isokinetic dynamometry were used to determine rearfoot motion, ground reaction forces, and knee muscular strength and endurance. Stepwise discriminant function analyses were performed on the anthropometric, biomechanical, and muscular strength and endurance variables. Q angle was a significant discriminator (P less than 0.01) between the INJ and C groups. The muscular endurance data revealed several significant discriminators with the INJ subjects being weaker in knee extension endurance. Kinetic analysis revealed several significant discriminators whereas rearfoot movement variables were not good discriminators between the groups. The training data revealed that the INJ group ran significantly less (P less than 0.01) miles.wk-1 than the C group. Our results suggest that Q angle is a strong discriminator between runners afflicted with PFP and non-injured runners. In addition, several muscular endurance and kinetic variables may also be important components of the etiology of PFP.
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27109
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Weyrich AS, Messier SP, Ruhmann BS, Berry MJ. Effects of bat composition, grip firmness, and impact location on postimpact ball velocity. Med Sci Sports Exerc 1991; 23:987. [PMID: 1956277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
The purposes of this investigation were to document the changes in stride length of college-age male novice runners (n = 13) who were allowed of freely choose their stride length throughout a 7-week training period (FCSL), and to compare subsequent changes in running economy to those observed in a similar group of runners (n = 13) that ran for 7 weeks with constant stride lengths equivalent to their initially chosen stride lengths (CSL). Subjects trained 3 days per week for approximately 7 weeks (22 training bouts). Each training bout consisted of a minute warmup (60% VO2max) and a 15-minute run at a speed equivalent to 80% of the subjects' initial VO2max. Absolute stride length (ASL), heart rate (HR), and ratings of perceived exertion (RPE) were measured during the 12th and 20th minute of exercise. Relative and absolute submaximal VO2 were measured during the 4th and 22nd training bout. No significant differences in percent change in ASL were found between the groups or across the weeks of training at the 12th or 20th minute of exercise; however, there was a significant difference (p less than or equal to .05) between the groups during the 4th week of training. No significant differences were found between the groups in relative or absolute submaximal VO2. Relative submaximal VO2 at the 12th minute of exercise decreased significantly following the training period in both the FCSL (-3.38%) and CSL (-4.32%) groups. Absolute submaximal VO2 did not change significantly following the training period.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S P Bailey
- J. B. Snow Biomechanics Laboratory, Wake Forest University
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Messier SP, Davis SE, Curl WW, Lowery RB, Pack RJ, Snow JB. 239 ETIOLOGIC FACTORS ASSOCIATED WITH PATELLOFEMORAL PAIN IN RUNNERS. Med Sci Sports Exerc 1990. [DOI: 10.1249/00005768-199004000-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Messier SP, Cirillo KJ. Effects of a verbal and visual feedback system on running technique, perceived exertion and running economy in female novice runners. J Sports Sci 1989; 7:113-26. [PMID: 2681819 DOI: 10.1080/02640418908729830] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The purpose of this study was to determine the effects of a verbal and visual feedback system on running technique, ratings of perceived exertion (RPE), and running economy. Twenty-two female novice runners were randomly assigned to experimental (n = 11) and control (n = 11) groups. The experimental subjects received verbal and visual feedback concerning their running technique prior to and during each training run. Training involved 15 20-min treadmill running sessions over a 5-week period. The control group adhered to the same training routine but did not receive feedback concerning their running technique. High-speed (100 Hz) photography was used to collect biomechanical data. A submaximal oxygen consumption test and Borg's RPE scale were used to collect data concerning running economy and perceived exertion, respectively. Statistical analysis using ANCOVA revealed that the proposed feedback system had a significant (P less than 0.01) effect on the experimental group's running technique by affecting the following desired changes relative to the control group: greater relative stride lengths, shorter support time, greater ankle dorsiflexion during support and greater knee flexion during support and non-support. There were no significant differences between the groups in submaximal VO2 or RPE. The results of this study suggest that verbal and visual feedback are effective means of eliciting modifications in running style in female novice runners. The link between modifications in running style and improvements in running economy and perceived exertion remains unclear.
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Wake Forest University, Winston Salem, NC 27109
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Messier SP, Cirillo KJ, Snow JB. EFFECTS OF A VERBAL AND VISUAL FEEDBACK SYSTEM ON RUNNING TECHNIQUE, PERCEIVED EXERTION, AND RUNNING ECONOMY IN FEMALE NOVICE RUNNERS. Med Sci Sports Exerc 1989. [DOI: 10.1249/00005768-198904001-00474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Weyrich AS, Messier SP, Ruhmann BS, Berry MJ. Effects of bat composition, grip firmness, and impact location on postimpact ball velocity. Med Sci Sports Exerc 1989; 21:199-205. [PMID: 2709983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The purpose of this investigation was to examine the effects of bat composition (aluminum and wooden), impact location [center of percussion (COP), center of gravity (COG), and end of the bat (E)], and grip firmness [tight (T) and no tension (NT)] on postimpact ball velocity. With the bats placed alternately in NT and T conditions, baseballs were delivered at a speed of 27.1 m.s-1 from a pitching machine positioned 1.5 m from the bat. High-speed photography (400 fps) was performed using a Locam camera positioned 7.54 m from and perpendicular to the principal plane of ball movement. A three-way ANCOVA revealed significant (P less than 0.01) differences in postimpact ball velocity between the three impact locations, with the COP yielding the greatest values, followed by the COG and E. Moreover, there was a significant (P less than 0.01) grip vs bat interaction. A simple-effects procedure revealed the following results: 1) the T grip produced greater (P less than 0.01) velocities than the NT grip across the aluminum (Al) bat; 2) there was no difference (P greater than 0.01) between the T and NT grips across the wooden (W) bat; 3) the W bat produced greater (P less than 0.01) velocities than the Al bat across the NT grip; and 4) there was no difference (P greater than 0.01) between the Al and W bats across the T grip.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A S Weyrich
- J.B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Wake Forest University, Winston-Salem, NC 27109
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Messier SP, Pittala KA. Etiologic factors associated with selected running injuries. Med Sci Sports Exerc 1988; 20:501-5. [PMID: 3193867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to determine whether a relationship exists between selected biomechanical, anthropometric, and training variables and runners afflicted with one of the following injuries: iliotibial (IT) band friction syndrome, shin splints, and plantar fasciitis. Competitive and recreational runners were divided into a non-injured control group (N = 19), an IT band friction syndrome injury group (N = 13), a shin splint injury group (N = 17), and a plantar fasciitis injury group (N = 15). Discriminant function analysis of the biomechanical data revealed two significant (P less than 0.05) discriminators between the control and shin splint groups; maximum pronation velocity and maximum pronation. Analysis of the anthropometric and training data revealed that plantar flexion range of motion was a significant (P less than 0.05) discriminator between the control and plantar fasciitis groups. In addition, analysis of the descriptive statistics (mean +/- SE) identified some non-significant (P greater than 0.05) trends between the injury and control groups: maximum pronation, total rearfoot movement, and maximum velocity of pronation were greater in the injury groups; the injury groups showed a trend toward a higher arch; dorsiflexion range of motion was less in the shin splint group; a greater percentage of injured runners had a leg length difference (greater than 0.64 cm); 20% more runners in the injury groups ran hills; and 20% more of the runners in the IT band friction syndrome group ran on crowned roads.
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Affiliation(s)
- S P Messier
- J. B. Snow Biomechanics Laboratory, Department of Health and Sport Science, Wake Forest University, Winston-Salem, NC 27109
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Messier SP, Pittala KA, Bowen S. 70. Med Sci Sports Exerc 1987. [DOI: 10.1249/00005768-198704001-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Messier SP, Owen MG. EFFECT OF STRIDE TECHNIQUE DURING BATTING ON GROUND REACTION FORCES AND BAT VELOCITIES. Med Sci Sports Exerc 1986. [DOI: 10.1249/00005768-198604001-00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Messier SP, Owen MG. LOWER EXTREMITY KINETIC RELATIONSHIPS IN FEMALE SOFTBALL BATTERS. Med Sci Sports Exerc 1982. [DOI: 10.1249/00005768-198202000-00287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Messier SP, Cirillo KJ, Snow JB. EFFECTS OF A VERBAL AND VISUAL FEEDBACK SYSTEM ON RUNNING TECHNIQUE, PERCEIVED EXERTION, AND RUNNING ECONOMY IN FEMALE NOVICE RUNNERS. Med Sci Sports Exerc 1980. [DOI: 10.1249/00005768-198004001-00474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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