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News Releases
MARRTC principal investigator presents at groundbreaking national event
Columbia, Mo. (August 1999) - More than 15 years ago, Marian Minor pioneered the idea that exercise, not rest is a key in treating arthritis.
In July, for the first time, a major national conference focused on prevention -- not just treatment -- of osteoarthritis. The conference "Stepping Away from OA," was sponsored by the National Institutes of Health (NIH) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
Minor, one of MARRTC's leading researchers for more than a decade, presented two new papers "Exercise Intervention in Osteoarthritis," and "Exercise and Fitness" at the 1999 conference. Minor's overall research suggests even moderate exercise levels improve the quality of life for adults with OA and help them better manage pain and depression. Exercise also improves the range of motion and mobility for a person with OA, Minor explained.
Minor's long-standing focus on the prevention of onset, progression and disability stemming from osteoarthritis is important because OA affects about 21 million adults in the United States. The disease results from the breakdown of cartilage in joints with associated joint pain and stiffness.
Minor is a principal investigator and co-principal investigator on two current projects in the Missouri Arthritis Rehabilitation Research and Training Center. MARRTC is the nation's only federally funded rehabilitation research organization focused on arthritis and its affects.
A physical therapist, Minor is also an associate professor of physical therapy at the School of Health Related Professions at the University of Missouri-Columbia.
Minor said this summer's conference was important for several reasons: it was the first time prevention of OA was discussed under the aegis of the National Institutes of Health. The meeting also attracted experts from diverse areas and emphasized that health care providers should care about more about joints when treating persons with osteoarthritis.
The more than three dozen presenters at the conference included experts in occupational therapy, exercise, nutrition, physical therapy and rheumatology, said Minor. Also at the conference were experts on biomechanics, which looks at the role of force and strength, and epidemiology, the study of the causes and the course of a disease.
Crossing the Lines
The conference emphasized the role of exercise and provided evidence that exercise is effective for prevention as well as treatment, Minor said.
"The discussion went beyond the medical model and beyond the traditional medical inputs," Minor said.
"One of the big points that was made at the conference is that the medical community and researchers need to move toward using a better way to measure the effects of arthritis on patients," Minor said.
Better measures, Minor explained, include assessing pain, loss of function and a person's reported quality of life, rather than assuming X-rays and images depict a patient's condition.
For example, Minor said, OA does not always show up through X-rays. In some cases, X-rays may show no sign of OA but a person may experience great pain or even disability. The opposite also can occur, she noted. Sometimes, X-rays show OA but a patient may not display any signs of the disease or feel any pain.
"This," Minor said, "tells us that its not just changes in cartilage and bone that are the sole cause of pain, weakness and loss of function. Muscle contributes, soft tissue contributes."
That's why, Minor said, health care providers are learning to look at muscle mechanics or how a person's muscles are routinely used.
Although attention to biomechanical and musculosketal facets of OA plus the role of occupation and activity are recent developments in the medical community, this summer's conference reinforced the important of supporting more work in this area, Minor said.
For example, papers suggested occupational stresses and movement patterns may contribute more to OA than health care practitioners realized, Minor explained.
The conference also was the first time a major meeting about the prevention of OA was open to the public, said Reva Lawrence, epidemilogy data systems program officer for NIAMS. About half of the more the 400 persons attending the conference were interested citizens.
Lawrence added the journal, Annals of Internal Medicine, has shown interest in publishing proceedings from the conference. The Annals is a journal of the American College of Physicians-American Society of Internal Medicine. It is considered a leading journal for internists and subspecialists.
Besides her papers at the meeting, Minor remains busy with other research. In February 1999, she authored with Marilyn K. Sanford, PT, Ph.D "The Role of Physical Therapy and Physical Modalities in Pain Management," in the quarterly journal, Rheumatic Disease Clinics of North America. In May 1999, her article on "Exercise in the Treatment of Osteoarthritis," was published in Rheumatic Disease Clinics of North America.
As her colleagues across the nation and across health disciplines converge on her ideas and approaches, Minor heartily approves.
"I think things are happening."
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