Archive for the ‘OA Research Blog’ Category
Dr. Lissa Fahlman
I remember forty years ago when my grandmother would get gold shots in her knees to help with her rheumatism. Not only did she periodically get the gold shots, she was on such a high dosage of aspirin that she often had ringing in her ears. She also had large nodes on her fingers and trouble with her hands. Like many people of her age, she wasn’t a complainer, but she was not able to do many of the things she wanted to do because of her arthritis and at times she was in terrible pain. More recently, I’ve watched as my mother has developed arthritis in her hands and knees. Fortunately, it hasn’t been as severe as my grandmother’s – even so, she is not as able to do some of the activities she enjoys. I wonder what will be in store for me? What about the next generation of my family? Since before the time my grandmother, little progress has been made in preventing osteoarthritis. Limited advancements in pain medications and surgical techniques have improved treatment somewhat. However, the CDC still ranks arthritis as the leading cause of
disability in the United States. I am fortunate to be working with ARIA and it’s worldwide unique Clearwater Osteoarthritis Study (COS) database to learn more about arthritis and provide the basis for future prevention and improved treatments.
Memories of my grandmother as I was growing up in northern Minnesota, vivid as they are, did not directly propel me into arthritis research. I spent my latter teens, 20’s, and early 30’s in exploring parts of Alaska via commercial fishing and working for the US Forest Service. I managed to earn a BS in Math during this time, as well. Next I followed my interest in health and complementary medicine, attending Western States Chiropractic College in Portland, Oregon. I began practicing in the Portland area; then bought a small practice on the Eastern Shore of Virginia. This
was a very interesting place to live and practice. In this medically under-served area, settled by whites and black slaves in the 1600’s (Martha Washington’s family had a plantation here), it was not uncommon to treat patients who were related and had problems. In treating multiple generations in some families, I was able to see what similar problems looked like in different life stages, but in real time. As would be expected, many of the older people I saw had complications due to arthritis. Many of the younger people I saw had injuries that would likely lead to arthritis. The middle-aged folks were in transition, beginning to experience some of the earlier symptoms of arthritis. This progression that I observed in my patients mirrored what I was seeing in my own family.
Although I loved my practice, in 2005 I sold it following a car accident that left me physically unable to continue to treat patients. Combining both my educational backgrounds (math & health), health research seemed a logical next step. In 2009, I graduated from the University of South Florida in Tampa with a Master’s of Public Health in Epidemiology. I began working with the ARIA research team in 2010. I am very excited to be able to apply my professional, educational, and personal experiences and observations in osteoarthritis research. As we are able to access
more of the COS data, I anticipate new findings which may, some day, lead to preventing and more effectively treating osteoarthritis. It is my hope that the next generations of my family and your, won’t experience what my grandmother did.
Paul E. Leaverton, PhD, Special Consultant
Paul E. Leaverton, PhD, Special Consultant
Retired ARIA Director of Research
My relationship with ARIA began in 1985, when I was Acting Director for Epidemiology and Biometry at the National Heart, Lung and Blood Institute at of the National Institutes of Health in Bethesda, Maryland. I had just accepted a new position as founding chairman of the Department of Epidemiology and Biostatistics in the new College of Public Health at the University of South Florida (USF) in Tampa. Early that summer, a quiet young man appeared at my door and asked for a few minutes of my time. He was Brian Burke, who had just begun working for a brand new research institute, ARIA, in Clearwater. Because I was administratively responsible for the Framingham (Massachusetts) Heart Study, upon which ARIA was modeled, he wanted to discuss some of the study design and data management issues. He was surprised to learn that I would soon be moving to the Tampa Bay area; a happy coincidence. I readily agreed to meet with Dr. Barrett and his staff shortly after that time. Thus began a long and, though intermittent, fruitful collaboration. Sometime after my retirement (2001) from USF, Dr. Barrett informed me that “I had flunked retirement” and would I become the new director of research at ARIA? Once again, I readily agreed. There was one caveat; I would continue in this capacity as long as it was fun. Now, after 18 months on the job, it is more gratifying than I could have imagined. Although all three of us on the research staff are part-time, we all very much enjoy working together and analyzing the valuable and voluminous ARIA data sets.
In the late 1980s, under the clear leadership of Dr. Barrett, with the advice of many scientists from around the country, the Clearwater Osteoarthritis Study (COS) took shape and became a reality. There is no question that the COS has become one of the most (if not the most) valuable data sets in the world by which to investigate the onset and natural progression of osteoarthritis (OA). Approximately 500 different variables have been recorded on over 3,700 volunteers over a 22-year period of time. Several subjects have data available for over ten years. Such longitudinal information is in persons with varying stages of OA provides the backbone of this epidemiologic study.
To date, there have been several ARIA publications adding to the scientific literature on the causes and progression of OA. However, in my opinion, the potential of the full data set has hardly been tapped. It is clear to all of us that many outstanding scientific contributions to the field are on the horizon. To ensure a scrupulously “clean” data set as we began new analyses, a project was launched a few months ago. We have labeled it the “Data Integrity Project” (DIP) and, with the unswerving, ongoing devotion of many ARIA volunteers, the entire COS data set is being re-entered and checked. A special report on the DIP will appear in a later newsletter.
The ARIA research staff consists of Epidemiologist Lissa Fahlman, DC, MSPH, Biostatistician Emmeline Sangeorzan, MPH, and me. To augment our capabilities, and taking advantage of the growing recognition of COS’s value, we have been gradually increasing our collaborative arrangements with scientists from other institutions. At this time, established investigators from the Universities of South Florida (Colleges of Medicine and Public Health), Georgia, Miami, Oxford University (UK), the National Center for Health Statistics, and The Florida Knee and Orthopedic Center, are involved in cooperative COS studies with ARIA staff. We are also ably assisted by a succession of graduate students from the
Department of Epidemiology and Biostatistics of the USF College of Public Health.
Enough of the Data Integrity Project has been completed that we are currently in the process of analyzing factors related to the early onset of knee osteoarthritis. Special reports on these and other important ARIA investigations will appear in forthcoming issues. Pardon the cliché, but it truly is an exciting time at ARIA. Every day, my staff and I are grateful for the many volunteers who are working so diligently to make possible all the current and forthcoming studies.
For additional information please visit www.preventarthritis.org.
Hand in Hand: Aching Fingers Improve with Exercise
Hand in Hand: Aching Fingers Improve with Exercise
Adults with hand osteoarthritis saw modest gains with targeted exercises
Squeezy, squishy hand stress balls may increase your grip strength and relieve pain in your hands while you’re taking out your frustrations about traffic and kids on them. A study of 76 adults with hand osteoarthritis (OA) found a modest increase in grip strength and pain relief over not using them or substituting the therapy balls for a placebo cream.
The study subjects ranged in age from 55 to 93. Almost 60 percent reported using pain medication more than four days a week for hand pain. The Arthritis Institute of America (ARIA) completed the study, which is only the second ever written on the topic of exercise and hand OA.
“There’s much evidence of the benefits of exercise and we know it improves OA in the knees and other sites,” said Matt Rogers, MS, one of the study’s authors and ARIA’s exercise director. “Hand strength is essential for daily living skills such as opening jars, turning keys in locks and holding objects. Even a modest increase can make these tasks easier.”
Rogers, a doctoral candidate, co-wrote the paper with Frances Vaughn Wilder, Ph.D, ARIA’s executive director. It was published in the peer-reviewed Journal of Hand Therapy. Arthritis is a group of different diseases whose symptoms can range from and conditions, its symptoms can range from stiff joints to complete immobility and pain. The most common type of arthritis is osteoarthritis, the “wear and tear” type that affects more than 27 million Americans after the age of 50 as their joints begin to age.
Since 1988, the Arthritis Research Institute of America (ARIA) has been studying thousands of participants to learn more about osteoarthritis. The 501 (c) (3) not-for-profit research organization is based in Clearwater, FL, but its findings have been published worldwide. ARIA’s x-ray database is globally acknowledged as one of the most complete sources of information about the progression of osteoarthritis. For information, call (727) 461-4054.