strategies to prevent knee OA disease progression or OA-related disability exist, in large part due to limitedknowledge of factors responsible for these outcomes. In recent years, there has been a shift inepidemiological studies towards heavier focus on progression than on the initial development of knee OA.Also, recognition of the role in progression of local factors is growing, especially those factors that modifyjoint loading. Recent findings support that hip muscle forces may play an important role in knee jointprotection in persons with osteoarthritic knees.In this application, we propose to examine the effect of hip muscle strength, particularly hip abductorand external rotator strength, on knee OA disease progression, physical function decline, and disabilityprogression in persons with knee OA. The proposed aims build upon results from our ongoing study. Along-term goal of the proposed project is to inform intervention development that capitalizes upon the hipmuscles to benefit persons with knee OA. We propose 2 evaluations (at baseline and at 2 years) of a cohortwith knee OA, in which we will measure strength of hip muscles as well as collect radiographic, magneticresonance imaging (MRI), functional status, and disability data, in order to analyze the relationship of the hipparameters at baseline to worsening of OA disease, physical function, and disability measures betweenbaseline and follow-up, using state-of-the-art approaches to assess each outcome. The equipment, pulsesequences, and quality of the MR protocol support quantitative assessment of articular cartilage.The results of this study will inform development of physical and rehabilitative therapy for knee OAthat might take advantage of the hip musculature. This is a key, modifiable aspect of the knee jointenvironment that has received little attention in knee OA, despite a potentially large role of hip muscles inboth knee-level and person-level function. The proposed study will include structural outcomes by MRI andby x-ray and person-relevant outcomes by self-report and task performance. Given the role played by thehip, it is plausible that hip muscle status will be linked not only to knee OA progression but also to associatedfunction limitation and disability.
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