The goal of this P20 Planning Grant Application from the University of Vermont is to build the infrastructure to support the intellectual interactions that will lead to a collaborative multidisciplinary clinical research program focusing on musculoskeletal function and dysfunction. The overall goal is to compete for a P60 Multipurpose Clinical Research Center Award. The University of Vermont and its affiliated teaching hospital, Fletcher Allen Health Care, has a wide range of successful, funded investigators working in basic, translational and clinical research fields with an emphasis on musculoskeletal disease. In addition, being the only tertiary health care facility in the State of Vermont, there are adequate numbers of patients with diseases which fall within the purvue of NIAMS and there is a past history of willingness of patients to enroll in and complete clinical research trials at the General Clinical Research Center and elsewhere in the outpatient system. The application details this research base and the supporting resources and existing Centers which will augment and foster the kinds of clinical research projects which will be included in the P60 application. The application also details the infrastructure which will be established to achieve these goals and our plans for the use of Internal and External Advisory Committees and the prominent role of the Biostatistics/Research Core. Finally, the application also includes examples of the kinds of interactions and synergies which have already arisen from the discussions of interested investigators. Examples include, but are not limited to, magnetic resonance imaging and outcomes studies to assess factors which lead to osteoarthritis of the knee following partial meniscectomy; the synergistic addition of studies of neuromuscular control to biomechanical studies in acute back injuries and ankle sprains; the application of basic science studies to determine maximal shortening velocity of muscle fibers, myosin and actin force and interaction, and mitochondrial function and DNA mutations in patients who have fibromyalgia syndrome; the use of an experimental dense multichannel EMG array in conjunction with real-time ultrasound imaging to gain a better understanding of the etiology of idiopathic low back pain; and studies of the interactions between eccentric exercise, muscle damage and postural stability with a view to reducing falls in the elderly and studying chronic musculoskeletal conditions such as rheumatoid arthritis and disuse atrophy. These or other examples could be further refined and expanded if this application were successful and where appropriate, the resources of the existing NIH-funded General clinical Research Center could be leveraged to perform resulting clinical research and outcomes projects.
