KNEEMO Kick-off Meeting Amsterdam, April 29-30, 2014

Transcription

1 KNEEMO Kick-off Meeting Amsterdam, April 29-30, 2014 D. Rosenbaum Funktionsbereich Bewegungsanalytik Institut für Experimentelle Muskuloskelettale Medizin (IEMM) Universitätsklinikum Münster

2 Münster Projects ESR-5 & ESR-6

3 Joint Load Reduction during Physical Activity ESR-5: 36 months (Supervisors: Rosenbaum & Harlaar) Objectives: 1.To identify joint loading patterns during physical activity in KOA patients 2.To evaluate changes in joint loading patterns due to biomechanical interventions (braces, orthotics) Tasks and methodology: Cross-sectional clinical studies in a human performance lab setting Results: Analysis of knee joint loading patterns during activity Analysis of biomechanical mechanisms underpinning non-pharmacological treatments (e.g. braces, orthotics) Reports on secondments at XST, GCU and PMU;

4 Previous Work Results & Conclusions Lateral wedges achieve an effective reduction of knee joint loads. Wedges could help to unload the medial compartment. Shoe sole modifications are more effective than wedged orthotics. However, ankle joint loads are increased.

5 Material & Methods Puma Street Cat sport shoes Experimental conditions: Bilateral shoe modifications Neutral shoes Medial wedge 10 Lateral wedge 10 Laterally wedged inserts

6 Effects on Frontal Knee & Ankle Joint Moments 0,50 0,40 Knie Abduktionsmoment (Nm/kg) normal Sohle aussen aussen innen 0,30 0,20 0,04 0,02 Ankle Eversions- & Inversionsmoment (Nm/kg) 0,10 0,00-0, Gait Cycle in % 0,00-0,02-0,04-0,06-0, Gait Cycle (%) -0,10 normal -0,12 Sohle aussen -0,14-0,16 aussen innen

7 Conclusion Pain relief and improvement in function reported by patients with OA while using lateral-wedged insoles may be achieved by a reduction in external varus moment and medial compartment load. Crenshaw et al., CORR 2000

8 Joint-aligning Knee Orthoses Seem to work (3-point-bending) but are not well tolerated/worn Counterforce2 Donjoy Monarch Bledsoe Thruster Bledsoe Aligner G2 Unloader

9 Treatment goals Pain management Improved quality of life Joint load reduction Altered gait mechanics Improved locomotion mobility independence Prevention of progress in joint degeneration Stabilization or improvement of joint situation

10 Physical Activity in the Daily Life of KOA Patients ESR-6: 36 months (Supervisors: Rosenbaum & Roos) Objectives: 1.To identify the level of free-living physical activity of KOA patients 2.To identify determinants of free-living physical activity Tasks and methodology: Prospective cohort study, including data collection at two time points with 1-year follow-up Measurements include free-living data and human performance lab assessments Gender, age, body weight, varus/valgus effects Results: KOA daily activity analysis Reports on secondments at XST, AAU and SDU(?) Collaboration with ESR-11 (Xsens) in developing and pilot-testing of the new kneespecific activity monitor

11 Study Design Methods: Quantitative and qualitative gait analysis 3-D movement analysis in the lab Physical activity assessment in daily life Tools: SAM, ActivPal, Heerlen Activity Monitor Goal: To assess the level of functional impairment and the consequences for mobility limitations in daily life

12 The KNEEMO Training Program Network Level & Individual Researcher Level

13 Scientific Training Objectives To give early and established career researchers specialist applied knowledge, skills and experience in: 1.Understanding the epidemiology, impact, burden and cost of KOA. 2.Understanding structure and function of the knee joint, anatomy and function in health and OA. 3.Performing imaged-based reconstruction of healthy and OA diseased knee joint anatomy. 4.Performing 3-D measurements of knee joint function during activities of daily living. 5.Understanding and applying the basic principles of computational modelling employing anatomical (3) and functional (4) data to better understand disease processes and pathology. 6.Understanding the need for early identification of patients and preventative action. 7.Understanding of current non-pharmacological interventions, their biomechanical basis and limitations. 8.Translating knowledge gained in (3) & (4) towards the development of novel, personalised biomechanical-based interventions. 9.Effective dissemination of scientific findings to peers, policy makers, private sector and lay public.

14 Transferable Skills Training Objectives Research leadership Organising and planning Entrepreneurship and innovation Ethics of human research Using information technology Intellectual property rights Effective communication, dissemination and outreach

15 Goals Develop core stability skills Not to build bulky show muscles skills Learning to conquer obstacles and to deal with problem Gather experience/proficiency in a variety of skills develop a valuable tool set

16 Structure of the training programme KNEEMO training programme will be implemented at network and individual researcher level. Ratio between training at individual and network level is typically 4:1 approximately 20% of their time in the training activities provided by the network project outside their host institution.

17 Training through research at host institutions Providing fellows with specific technical and research training for their project. Fellows will have a supervisory team comprising at least one internal (host institution) and one external (other KNEEMO partner) leading academic in the field. Specific technical and research training needs will be identified and addressed in the fellow s project through: a. formal training (courses etc.), b. experiential training through focusing on areas in need of development during the project s progression c. the KNEEMO Virtual Learning Environment (VLE) which provides ad-hoc access to a wide variety of expertise present within the KNEEMO consortium

18 Training through inter-sector exchange visits and secondments 3 secondments for each ESR and 2 secondments for each ER will be implemented. One secondment will primarily support a main task closely linked to the fellow s project. An additional academic secondment will be aimed at expanding expert knowledge in another specialist area, while an industrial secondment will be aimed at applying knowledge, skills and experiences to challenges in the industrial sector and to experience a private sector environment. All fellows based in academia will undertake an industrial secondment.

19 Requirements All ESRs and ERs will be required to formulate a Personal Career Development Plan early in their project which will identify their personal training needs. All ESRs will be registered as a PhD student at their host institution and enrolled in that institution s PhD programme. ESR11, based at SME partner XST will be registered as a PhD student at Twente University.

20 Local Training Activities Career development plan Graduate school/center training Good clinical practice training Employment skills training Pastoral support, career guidance, mentorship

21 Network Training: 4 Scientific Workshops 1. Workshop on KOA disease burden & OA epidemiology Free University, Amsterdam, NL 2. Workshop: KOA Biomechanics WWU, Münster, D 3. Workshop: Advanced computational knee modelling Aalborg Universitet, Aalborg, DK 4. Workshop: Non-pharmacological KOA interventions Syddansk Universitet, Odense, DK

22 Network Training: 4 Scientific Workshops 5-day events Focused on 1 scientific aspect Invited lectures (researchers, clinicians, patients) Presentations of ESRs & ERs Practical training, hands-on experience, skills training

23 Network Training: 1-Week Summer School Glasgow Caledonian University, Glasgow, UK Invited lectures by experts in the field Focused on generic and transferable skills training Practical skills training Grant writing Writing a publication Preparing and giving a presentation Innovation and enterprise Dissemination and outreach

24 Network Training: The KNEEMO Conference Final network activity linked to a relevant international conference in Europe 2-day International Satellite Symposium Dissemination of KNEEMO findings to a large and well-informed audience