Stratified Care and Personalised Medicine: Care (WP2)

Work Package Leads:

• Maria Stokes (Southampton)
• Jonathan Folland (Loughborough)
• James Bilzon (Bath)

Primary Location:
Southampton/Loughborough/Bath/NUHT

Wokring Group:

• Cathy Bowen and Markus Heller (Southampton)
• Dylan Thompson (Bath)

Research Questions:

1. What is the effectiveness of non surgical interventions for the prevention and management of osteoarthritis to enable lifelong physical activity?

2. Can targeting treatment, based on individual key characteristics (stratified care/phenotyping) improve a patient’s outcome?

Summary:

This work package will utilise the results of ‘early disease and risk prediction’ (WP1) to inform and improve the design and efficiency of targeted intervention studies, through enhanced stratified care. These studies, in turn, will inform studies on ‘life course impact’ (WP3). Reliability and validity of outcome measures, and proof of concept of intervention studies in the first phase of the Centre have laid the foundation for developing randomised controlled trials (RCTs). We will examine the clinical and cost effectiveness of conservative interventions (i.e. physical activity, targeted exercise programmes, topical treatments and orthoses) to protect joints by preventing and managing musculoskeletal dysfunction. Qualitative aspects of these studies will inform studies in WP3, aiming to promote long-term adherence to safe, effective exercise for musculoskeletal health, specifically for improving adherence to neuromuscular training, re-educating control of movement and explosive training.  Nested studies to examine biomechanical and neurophysiological mechanisms of action will be key to understanding and refining targeted interventions to make them efficient and effective. Mixed methods research, employing quantitative and qualitative techniques, is a feature of our approach to ensuring outcomes, and clinical and cost effectiveness are examined alongside impact on quality of life.

Aims:

1. Targeting exercise interventions for the physically active: from primary to tertiary prevention*

2. Development and evaluation of practical training programmes/exercise methods for older adults.

3. Evaluate optimal modifiable intervention strategies for maintenance of physical activity in retired athletes.