Theme 3 – Interventions to Improve Musculoskeletal Health and Function

This theme investigates the assessment of lifestyle, but also pharmacological interventions, in healthy, frail and disease populations to improve musculoskeletal (MSK) health and function, including approaches to increase adoption of lifestyle change. This theme involves 24 PrincipaI Investigators and their teams and benefits from access to clinical research facilities and trials units at both the University of Nottingham and the University of Birmingham. Sub-themes include:

Physical activity and nutritional interventions

Investigating the combination of nutrition (the leucine metabolite HMB) with resistance exercise to increase muscle function in frail elders in a community setting.

Working with industry to test a range of nutrients, including fish oils and phosphatidic acid to improve muscle quality

Evaluating the efficacy of diet and exercise interventions on metabolism, including the timing of exercise in relation to nutrient intake

Supplementing older adults with nicotinamide riboside to restore muscle NAD+ levels and improve muscle function

Developing and testing lifestyle interventions, including High-Intensity Interval Training (HIIT), to optimise fat oxidation and reduce lipotoxic stress in muscle

Using HIIT in a pre-habilitation setting testing its ability to build up MSK reserve in older patients undergoing elective surgery

Large-scale, community-based evaluation of physical activity enhancement and falls prevention programmes in the community

Assessing diet and exercise interventions in ethnically diverse communities who remain under-studied in the UK

Pharmacological and bioengineering interventions targeting MSK frailty or disease

In certain situations, diet or physical activity are inappropriate or poorly adopted by patients. Therefore research in this theme also incorporates pharmacological and bioengineering interventions, this includes:

Using anabolic agents (DHEA) to overcome trauma (hip fracture as well as major trauma) related sarcopaenia and re-set the HPA axis

Using a novel B cell population, FcRL4 expressing, that accumulates with age and in Rheumatoid Arthritis (RA) and are major autoimmune effectors, developing antibodies to delete these cells.

Developing delivery methods for cell therapy to regenerate bone, cartilage and tendon

Using non-invasive brain stimulation to improve motor control.

Approaches to motivate people to make lifestyle changes

This sub-theme develops approaches to motivate people to make lifestyle changes, areas of interest are:

Applying self-determination theory to increase physical activity and reduce pain and fatigue in patients with RA

Home-based and community interventions to increase stair climbing and improve leg strength

Working with the community to assess the efficacy of different programmes for weight loss, increasing physical activity and self-management of chronic disease, all benefitting MSK health.

Theme 3 Leads

Carolyn Greig, University of Birmingham

Ian Macdonald, University of Nottingham