Browsing by Subject "Osteoarthritis"

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The efficacy of swimming and cycling training in individuals with osteoarthritis : a randomized controlled clinical trial
(2015-05) Alkatan, Mohammed; Tanaka, Hirofumi, Ph. D.; Stuifbergen, Alexa M; Kohl, Harold W; Steinhardt, Mary A; Brothers, Matthew R
Osteoarthritis (OA) is the number one cause of disability among older adults and is associated with cardiovascular disease (CVD) due, at least in part, to sedentary lifestyle in OA. Symptoms of OA such as joint pain act as a significant barrier for middle-aged and older adults attempting to perform physical activity. Thus, swimming can be an ideal form of exercise for patients with OA as it is non-weight bearing and would not aggravate symptoms of OA. However, there is no information available regarding the beneficial effects of regular swimming exercise involving patients with OA. Accordingly, the general aim of the present study was to determine the effects of a 12-week swimming exercise intervention on functional capacity, pain, vascular function, and markers of inflammation in middle-aged and older adults with OA. Using a controlled, randomized study design, forty-eight sedentary middle-aged and older adults with OA underwent 12 weeks of either swimming or cycling exercise training. Cycling exercise was used as a land-based exercise comparison group. All exercise sessions were closely supervised and consisted of 45 minutes/session 3 days/week at 60-70% heart rate reserve. In Study 1, we assessed changes in functional outcomes and pain. Participants in both swimming and cycling exercise training groups demonstrated significant increases in distance covered during the 6-min walk test, as well as maximal grip strength and isokinetic knee extensor and flexor strength. We observed decreases in body mass, visceral adiposity, and waist and hip circumference in both exercise training groups. Additionally, there were reductions in pain and stiffness accompanied by increased physical function, as determined by the WOMAC index, in both groups. It should be noted, there was no advantage in the swimming or cycling group in any of these measurements. In Study 2, we investigated improvements in vascular function and markers of inflammation. We observed significant reductions in central artery stiffness following both exercise interventions, and the arterial destiffening effects were observed all across various measures of arterial stiffness. A significant improvement in endothelium-dependent vasodilation, as determined by brachial flow-mediated dilation, was observed after the swimming, but not after the cycling exercise training. Furthermore, both exercise training groups significantly decreased levels of the inflammatory marker, IL-6. Taken together, results suggest that swimming exercise was effective in improving physical function and vascular function as well as in reducing pain in middle-aged and older adults with OA. These findings are of paramount clinical importance to patients with OA, as swimming may be a desirable mode of exercise, but is often viewed as inferior to land-based exercise in regards to maximizing health benefits gained from exercise.
Modeling heterogeneities in disease risk : mapping COVID-19 and identifying osteoarthritis
(2024-05) Javan, Emily Morgan ; Meyers, Lauren Ancel; Gaither, Kelly P.; Narasimhan, Vagheesh M.; Wilke, Claus O.
Differences in disease risk and observed outcomes arise from heterogeneities in both environmental and genetic factors within a population. By identifying the drivers of risk, we can improve public awareness and design interventions to mitigate human suffering. Here I investigated the complexities of disease risk in human populations through three studies that utilize COVID-19 case data in the United States and hospitalization records from Austin, TX, and the United Kingdom. First, I modeled the risk of an undetected COVID-19 epidemic for each US county at the start of the pandemic. By March 16, 2020 once a single case was detected a county had a mean epidemic risk of 71% (95% CI: 52-83%), implying COVID-19 was already spreading widely by the first detected case. I reinforced public support for proactive measures given the virus' widespread presence before testing was widely available. Second, I explored the spatial and temporal disparities in COVID-19 deaths, hospitalizations, and infections. By comparing ZIP codes ranking in the 75th percentile of vulnerability to those in the 25th percentile, we found that the more vulnerable communities had 2.5 (95% CrI: 2.0–3.0) times the infection rate and only 70% (95% CrI: 60%-82%) the reporting rate compared to the less vulnerable communities. Inequality persisted but declined significantly over the 15-month study period, highlighting the excess COVID-19 burden suffered by vulnerable populations within Austin, TX. Lastly, a co-author employed deep learning on DXA scans of adult knees (mean age 64) from the UK Biobank and identified 1931 (178%) more cases of severe knee osteoarthritis than currently diagnosed in the health record. I performed a genome wide association study on the image derived quantitative measure of joint space width that identified these new cases and compared them to the standard binary case-control phenotype. The quantitative measure increased the number of genome-wide significant loci discovered from 6 to 18, despite the two phenotypes being highly genetically correlated (−0.92). My dissertation identifies latent predictors of disease risk for both infectious and degenerative diseases across spatiotemporal scales within diverse human populations.
Predictors of disability in middle-aged and older African American women with osteoarthritis
(2014-12) Walker, Janiece Lynn; Harrison, Tracie C., 1968-
Given the percentage of African American women in the general U.S. population, the number of African American women with functional limitations and disabilities is disproportionate; although chronic conditions such as osteoarthritis may contribute to these disparities it is unclear what environmental factors may affect these outcomes in the women. Hence, the purpose of this study was to examine biological factors (age, body mass index, and waist circumference), psychosocial intra-individual factors (health care utilization, trust in health care providers, pain, pain beliefs, and depression), and cumulative extra-individual environmental factors (racial discrimination, stress from racial discrimination, and health care access) that may influence function and disability outcomes in African American women with osteoarthritis 50-80 years of age. The disablement process model combined with the cumulative inequality theory served as theoretical guides used for this study. This study was a non-experimental, descriptive correlational study. The study included a sample of 120 African American women with OA from Texas and New Mexico. Surveys were mailed to participants or distributed in person. The statistical analysis consisted of correlations, linear regressions, multiple regressions and hierarchical regressions. The significant predictors of function were BMI, pain severity and pain beliefs. Pain severity and pain beliefs predicted disability. Depression mediated the relationship between racial discrimination and disability. It was demonstrated that biological risk factors, intra-individual and extra-individual factors are related to disablement outcomes in this sample of African American women. This study can inform the development of future interventions designed to decrease the risk of functional limitations and disabilities in middle-aged and older African American women with osteoarthritis.