Healthy Loading to combat osteoarthritis: Leveraging molecular variations in load bearing capacity for individualized movement aDvice: The LoaD project

Osteoarthritis, a painful and disabling joint disease, impairs everyday life activities of 1.5 million people in the Netherlands. Osteoarthritis cannot be cured; current treatment focuses on reducing symptoms. Patients are encouraged to stay physically active, but the effects of type and intensity of physical activity, and thus joint loading, on disease progression are not known in general, let alone at the molecular level nor the level of the individual patient.
Driven by and together with patients, the LoaD consortium will optimise joint loading to stop disease progression with strategies to support patients in dealing with osteoarthritis in daily life. This will contribute to extra healthy years and increased societal participation of patients. We will bring the understanding of how joint loading affects osteoarthritis in the individual patient to an unprecedented level by integrating expertise from different disciplines. In cohorts of osteoarthritis patients, we will investigate how movement type, frequency and duration are linked to pain and disease progression and study the relationship with personal characteristics, such as sex, weight, age, joint anatomy, quality of movement and psychosocial aspects. By using multi-scale techniques, we will study physical activity from mechanical loading at joint level to cartilage tissue, to cell, and even to molecular level. Beyond state-of-the-art cell models will be used to examine how individual genetic variation and differences in inflammation influence responses to mechanical loading. All knowledge will be combined into digital composite biomarkers and real-life monitoring and used to develop personalised eHealth-supported strategies. Using a randomised field study and cost and health impact analyses, we will evaluate the use of the developed technologies and identify the most effective and affordable strategies to implement real-time personalised advice on health joint loading to patients with osteoarthritis in daily life.