Talking the walk
UCalgary’s Running Injury Clinic is taking on osteoarthritis of the knee with a precision medicine approach.
For thousands of Canadians living with osteoarthritis, aches and pains are routine and the unfortunate reality of one of the most common forms of arthritis. In Canada, osteoarthritis of the knee affects one in eight Canadians at a cost of nearly $30 billion per year.
Reed Ferber, associate professor in the faculties of kinesiology and nursing, and director of the Running Injury Clinic at the University of Calgary — along with a team of researchers — hopes that a new way for treating this condition will help minimize pain and improve function for those living with the disease.
For those who have osteoarthritis (OA), exercises are commonly prescribed to help minimize pain and improve function. Previous research has shown that therapeutic exercises may work for some but not for others, explains Ferber.
“The one size fits all approach for treatment is changing to a precision medicine approach," he says. "Our research has focused on developing a way to predict who will respond to treatment and who will not.”
Through analysis of 3D walking biomechanics, coupled with information obtained through a patient questionnaire, researchers can predict with 85 per cent accuracy, whether a patient will benefit from an exercise program (high responders), show limited response and need a customized program (moderate responders), or have no response at all (low responders).
A high responder will benefit greatly from the exercise program. Says Ferber, “they have a lot of pain, are low functioning, and walk very atypically. The program we developed reduces their pain by nearly 80 per cent in some cases and restores more 'typical' walking mechanics.”
At the opposite end of the spectrum are low responders, who, according to Ferber, are actually the happiest.
“They have relatively low pain, are high functioning, and they walk very much like a person who is healthy and does not have OA,” he adds.
This research is significant in developing an objective system to help clinicians make evidence-based decisions regarding optimal treatment for patients with knee OA. It is already being used around the globe.
“We have already translated this research directly into clinical practice and the analysis is currently being used at the Running Injury Clinic here in Calgary and also with some of our partners in Perth, Australia; Victoria B.C.; Kingston, Ontario; and Halifax, Nova Scotia,” says Ferber.
The University of Calgary’s multidisciplinary Engineering Solutions for Health: Biomedical Engineering research strategy is focused on pressing health challenges like disease and injury prevention, diagnosis and treatments. These advances also apply systems engineering principles to continuous improvement of the health system.