Predicting response to exercise in knee osteoarthritis patients

Lower limb osteoarthritis is a common musculoskeletal condition worldwide. Symptomatic knee and hip osteoarthritis presents in 10% men and 13% in women aged 60 years or older (Zhang and Jordan, 2010). Due to the ageing population and an increasing incidence of obesity, the prevalence of osteoarthritis in the western world is expected to rapidly and dramatically escalate to 40% of over 60 year olds in the next 20 years (Belo et al, 2007; Woolf and Pfleger, 2003). Nonetheless, osteoarthritis can also present in younger patients as well as older individuals. This will have a major impact on healthcare provision and cost.

Osteoarthritis is a disabling disorder which impacts on people’s daily activities and quality of life, leading to reduced participation in physical activity. This latter consequence is identified as a major risk factor for further functional decline and loss of independence, with considerable social and health care costs. It is therefore of major importance to health care, social care and governmental organisations who provide financial support towards the management of these people’s symptoms.

This study will identify which people with knee osteoarthritis are more likely to respond to exercise prescription, and will suggest how exercise may be modified for those with poorer response. This will better direct healthcare resources to improve patient outcome and signpost therapists to those likely to need additional support. All study participants will be prescribed exercises and advice. Clinical and economic outcomes will identify who currently gains clinical benefit during a 6 month follow-up.

The studentship will provide the candidate with an exciting opportunity to develop skills in quantitative research design and research synthesis, specifically in epidemiology. In addition they will gain knowledge on the methodological decisions required to design such a study, the experience of ethical review procedures, practice in study management, in addition to skills in statistical data analysis and dissemination. The supervisory team will comprise of Professor Catherine Sackley and Dr Toby Smith, with statistical advice from Professor Lee Shepstone. The Faculty of Medicine and Health Science has developed excellent links with primary care researchers and research networks nationally. This will assist in the recruitment and data collection of this multi-centre study.

This programme of study will fulfil two goals. Firstly it will provide important new research on the management of people with osteoarthritis of the knee. Secondly, it will provide the PhD student with an opportunity to develop their knowledge of clinically-orientated research.