Embracing research in all four pillars of CIHR (from cells to populations) and all foci of IMHA: Arthritis, Rehabilitation, Bone, Muscle, Skin, and Oral Health research, the Physical Activity, Mobility and Health theme is based on the central concept that physical activity, mobility and the ability to play sports are all known to be a function of the health of the musculoskeletal (MSK) system and its components. Without "MSK health", it is generally known that personal well being will be compromised. This research initiative is therefore focused on turning general knowledge into specifics - supporting any research that will create new knowledge, or translation of existing knowledge, regarding the maintenance, improvement or restoration of "MSK Health" as a critical component in improving overall health and well-being, as well as the influence of positive or negative "MSK Health" on all other body systems.
Research performed under this theme should create a better understanding of the relationships between physical activity, mobility and MSK health at every level - from the positive effects of motion and forces on the cellular behavior of joint tissues and the well-being of individuals, up to impacts of physical activity (or lack thereof) on maintaining healthy populations. It should also include research on specific knowledge translation techniques, health services/health systems and/or any policies that pertain to improving MSK Health in individuals or populations through physical activity and/or sport. This would clearly include research on any tissues in and around joints (bone, articular cartilage, ligaments, tendons, fibrocartilage, muscles, synovium, nerves, blood vessels, joint fluid) in health and/or in disease as well as understanding responses of corresponding or similar tissues in other environments (e.g. in the mouth). It should also include research on the physiology and interactive biology of these MSK (and related) tissues in and around joints and how joints function in individuals (biologically, mechanically, physiologically, etc), as well understanding the psychosocial aspects of maintaining joint health, treating bone and joint injury, encouraging prevention and overcoming all barriers to people being able to achieve healthy levels of physical activity, mobility and sport.
The second (related) aspect of this research theme is aimed at defining the thresholds beyond which MSK physical activity, mobility and sport-related activities are "good" (create health), versus where they can cause injury or disease. The importance of exercise and movement in ageing populations in maintaining musculoskeletal health and in the management of injuries and arthritis is required. Not enough activity is known to be harmful and similarly, too much activity can presumably cause either temporary or permanent injury, inflammation and/or disease. Understanding these thresholds, their specific mechanisms and all of the factors that are involved in their violation (physical, psychosocial, etc) is a major IMHA strategy in MSK injury and disease prevention, treatment and MSK rehabilitation (e.g. preventing or treating chronic musculoskeletal diseases including arthritis, osteoporosis, etc).
A healthy musculoskeletal (MSK) system is fundamentally linked to an individual's ability to be mobile and physically active. More to the point, however, is the fact that personal well being, and the health of many if not all other body systems, is negatively impacted when musculoskeletal health is impaired. While these are commonly accepted principles, the real challenge for researchers is to take this general knowledge one step further. In other words, to conduct investigations that will help us better understand the complex relationships between physical activity, mobility, MSK health and overall health at every level. To do so, we need to find answers to a broad array of questions. The following are just a few examples:
In order to define the direct or indirect impacts of musculoskeletal physical activity and mobility (or lack thereof) on "non-MSK" diseases, conditions and body systems, IMHA will seek to form partnerships with other CIHR institutes and their stakeholders and other relevant organizations. (Note: Research questions studying any such linkages (mechanisms, causes, prevention) of any/all major diseases, condition and body systems will be considered for funding by IMHA as long as physical activity/mobility is being studied specifically and/or varied as part of the research protocol. Projects in which physical activity is a "tool only" will be of less interest to IMHA). As with all IMHA and CIHR research themes, research on knowledge translation as it relates to all aspects of this theme will also be supported.
The Tissue Injury, Repair and Replacement theme will once again encompass all four pillars of CIHR (from cells to populations) and all foci of IMHA: Arthritis, Bone, Skin, Muscle, Oral Health and Rehabilitation research. It is well known that injuries to bones (fractures), joints (bone, soft tissues, cartilage, etc), muscles (including tendons), teeth (including other oral tissues) and skin (wounds and burns) are all extremely common and recover slowly, if at all. While many are injured grossly, even more are likely damaged at a microscopic level by a variety of processes (loading, biochemical or inflammatory injury, infection, external factors (e.g. toxins, chemicals, sunlight, etc)- at home, in the community and in the workplace.
Genetic diseases of relevance to IMHA (e.g., muscular dystrophy etc.) likely predispose people to injury and interfere with repair in ways that need to be further defined and prevented. Healing of all of these tissues (and their surrounding tissues) is generally painful, slow and incomplete (inflammation and scar formation are not true regeneration). And the majority of these conditions often require lengthy and expensive treatments including rehabilitation, grafting or replacement (e.g. joints, teeth, skin etc.) An unacceptable number also result in chronic cosmetic, psychological and/or physical disabilities. Not surprisingly, the pain and financial burden placed on individuals and their families can have a considerably negative impact on quality of life. In light of this, we have an urgent need for highly innovative research into the cause and prevention of the physical, psychological, psychosocial and economic impact of these broadly defined (acute and chronic) injuries. In addition, we need to generate a more thorough understanding of the biological, clinical, psychological health services and population-based aspects of injury and repair.
To this end, IMHA will support research that addresses all replacement options, including natural possibilities (local or systemic) as well as potential bioengineering solutions (biological, artificial or combined). Research that helps us better understand the importance of the endocrine system and nutrition in the maintenance of skeletal health and MSK repair is also encouraged.
Potential research areas (eligible areas include bone, joint tissues, skin, muscle, oral tissues):
As with all IMHA and CIHR research themes, research on knowledge translation as it relates to all aspects of this theme will also be supported.
All four pillars of CIHR (from cells to populations) and all foci of IMHA: Arthritis, Bone, Skin, Muscle, Oral Health and Rehabilitation research (the latter as it pertains to the MSK system) will also be addressed under the Pain, Disability and Chronic Disease theme. Unfortunately, pain and disability (disability being defined both physically and psychologically) are very common sequellae of all chronic diseases (congenital and acquired) that exist within all IMHA-relevant areas (bones, joints, muscles, skin, and oral health). They can affect people of any age, with a number of congenital conditions being relevant (e.g. muscular dystrophy, osteogenesis imperfecta, etc.). But, for reasons requiring further exploration, these diseases and conditions all become more common with aging. For most IMHA-relevant conditions, females are generally affected more often than males - again, for reasons that remain elusive. Further, the incidence of pain and disability varies by age, gender, socioeconomic status as well as a number of other (as yet unknown) genetic and environmental factors.
The primary focus of research under this theme is to better understand the genetic and environmental causes, optimal treatment and elimination of pain and disability in all relevant IMHA disease areas. Equally important is research that will either directly or indirectly lead to the prevention of pain and disability in all IMHA foci. The mechanisms and causes of pain and disability must be identified and the biological, clinical (including psychosocial), health services and/or population health strategies aimed at decreasing and eliminating those entities are encouraged.
With the support of partner institutes and other interested stakeholders, a second area of strategic focus falling under this initiative is the need to understand the relationships between chronic diseases and conditions within IMHA's mandate (e.g. oral health and arthritis; oral health and bone diseases; skin disease and bone diseases; etc) and those between IMHA diseases/conditions and those diseases and conditions beyond IMHA's mandate (e.g. relationships between oral health and health of other systems: heart disease, lung diseases, stroke, diabetes, obesity). Any permutation and combination of IMHA foci and other diseases could also be pursued. Research that describes associations will be supported, but research looking at potential cause-and-effect relationships (with treatment and/or prevention strategies) will receive particular attention.
Over the next two decades, the prevalence of many chronic diseases and conditions is going to increase, consuming a far greater proportion of Canada's health care resources. Unfortunately, chronic pain, loss of mobility and function, and loss of independence are common outcomes of a host of IMHA-related conditions from arthritis, metabolic bone disorders and fractures, to osteoporosis, periodontal disease and soft tissue injuries. To shed light on the mysteries associated with pain, disability and chronic diseases, IMHA will support research that will:
As with all IMHA and CIHR research themes, research on knowledge translation as it relates to all aspects of this theme will also be supported.
