ARCHIVED - Research About – Musculoskeletal Health and Arthritis

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For the past 10 years, the Canadian Institutes of Health Research (CIHR) has supported better health and health care for Canadians. As the Government of Canada's health research investment agency, CIHR enables the creation of evidence-based knowledge and its transformation into improved treatments, prevention and diagnoses, new products and services, and a stronger, patient-oriented health-care system. Composed of 13 internationally recognized Institutes, CIHR supports more than 13,600 health researchers and trainees across Canada. Through CIHR, the Government of Canada invested approximately $77.7 million in 2009–10 in musculoskeletal health and arthritis research.

The Facts

• More than 4 million Canadians have some form of arthritis – an umbrella term that includes 100 conditions, the most common of which is osteoarthritis.¹
• In the 2009 Survey on Living with Chronic Disease in Canada, 30% of people with arthritis rated their general health as fair or poor and 21% felt the need for help with their emotions, stress or mental health to manage their condition.²
• According to the Canadian Community Health Survey, one in seven, or 4.1 million Canadians aged 12 and older suffered an activity-limiting injury in 2009. More than one-third of these injuries occurred during sports or physical exercise.³
• The most common cause of injury is falling. In 2009, nearly 1.7 million people, or 41% of those who reported an injury, said they hurt themselves in a fall.⁴

Sources:

1. Statistics Canada: Arthritis by sex provinces and territories 
2. Public Health Agency of Canada: Chronic Diseases Arthritis
3. Statistics Canada: The Daily Canadian Community Health Survey
4.  Ibid.

Finding Solutions

Sprain study participants to get same treatment as athletes

Up to 40% of ankle sprains result in chronic functional limitations that may affect work and leisure activities. That's why researchers at Queen's University are investigating whether all people with ankle sprains might benefit from the intensive physical therapy that professional and elite athletes receive. Drs. Brenda Brouwer and Robert Brison are recruiting about 500 subjects for a clinical trial to investigate the effectiveness of a physical therapy intervention for people who go to emergency departments with ankle sprains. "This study will demonstrate whether the early use of physical therapy in patients with ankle sprains may reduce the long-term pain and residual impairment these injuries are often associated with," says Dr. Brison.

Painless procedure can predict periodontal disease

Periodontal disease – an inflammation of the tissues that surround and support the teeth – often goes undetected while it destroys bone and ligaments that support teeth. Beyond causing dental difficulties, it also sends chemicals into the bloodstream that can negatively affect other organs or worsen existing conditions such as rheumatoid arthritis. Dr. Michael Glogauer of the University of Toronto has developed a simple test that can be done in the dentist's office to detect elevated inflammatory cell counts in the mouth – an indicator that the condition is present well before any symptoms become evident and damage is done. CIHR-funded Dr. Glogauer is working with a Canadian company, CHX Technologies, to take the rinse to market.

Shorter stay for hip surgery leads to better recovery

Sometimes less really is more. Dr. Nizar Mahomed of Toronto Western Hospital and the University Health Network led a randomized controlled clinical trial involving hip and knee replacement patients and found that patients recovered more quickly and completely when they spent fewer days in hospital after their surgery. The findings led to the creation of the Total Joint Network to develop and implement standardized models of care for joint replacements and hip fractures to improve outcomes, cut costs and improve processes. The improvements are now being implemented across Ontario via the Bone and Joint Health Network. "It's a real win-win from all stakeholders' perspectives," says Dr. Mahomed. "We've improved the efficiency of care, we're providing better health care and saving the system a significant amount of money."

Search continues for bone-healing stem cells

Dr. Laurie McDuffee of the University of Prince Edward Island is investigating ways to use stem cells to regenerate brittle or broken bones. A pilot study with animals showed promising results, but data from a follow-up study, which are still being analyzed, indicate a different carrier or different source of stem cells may be needed to promote stronger healing. "We were using stem cells derived from the periosteum (the membrane around the bone) for the study," says Dr. McDuffee. "We're now looking at fat-derived and bone-marrow-derived stem cells. The question is, do all these stem cells from different sources have the same osteogenic potential? That's what we're trying to evaluate."

Researcher getting message out that surgery is not needed

Dr. Bob Litchfield of the University of Western Ontario has proven that arthroscopic knee surgery to remove bits of torn cartilage and smooth rough edges of the joint surfaces does no more to help people with arthritis than physiotherapy and education. So now he is trying to get the word out to doctors to put down the knife. "Much of medicine is doing what you've always done, and what has always been done for this group of patients is arthroscopy," says
Dr. Litchfield, winner of a 2009 CIHR-CMAJ Top Canadian Achievements in Health Research Award. "Many surgeons may not have heard of the work and incorporated change into their practice." Dr. Litchfield, who tracked patients for up to two years and found no difference between those who received surgery and those who didn't, recently reported his findings at a conference in Vienna that drew 1,200 surgeons.

For More Information

Move It or Lose It! Musculoskeletal (MSK) health, including muscle, joint, and bone health, is dependent on optimal amounts of physical activity. MSK disorders such as osteoporosis and arthritis can limit mobility and ability to be physically active, creating a vicious circle of inactivity and MSK degeneration. The CIHR Institute of Musculoskeletal Health and Arthritis (CIHR-IMHA) is working to better understand and treat MSK (including skin and oral) diseases and injury and to improve the health of Canadians by focusing on our flagship theme of physical activity. To learn more about these priorities and other CIHR-IMHA activities, please visit the Institute's website.

For more information, go to ARCHIVED - Your Health Research Dollars at Work