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dc.contributor.authorKrishnasamy, Priathashini
dc.date.accessioned2019-07-09T02:41:16Z
dc.date.issued2019-02-15
dc.identifier.urihttp://hdl.handle.net/2123/20699
dc.description.abstractSkeletal muscle quality may play a role in skeletal muscle health affecting its response to muscle strengthening exercises and susceptibility to osteoarthritis (OA). Chapter One of this thesis provides an introduction to the role of skeletal muscle in the incidence, progression and exercise management of knee OA. Chapter Two examines skeletal muscle quality (muscle attenuation and lean muscle volume), knee extensor strength and percentage whole-body fat as mediators in the symptomatic and functional improvements achieved in a diet and exercise (D+E) compared to D (diet) or E (exercise) interventions. Null mediation results were found for skeletal muscle quality and knee extensor strength. However, a reduction in the percentage of whole- body fat significantly partially mediated pain, function, 6-minute walk test and gait speed improvements achieved in the D+E compared to E groups. Chapter Three presents the relationship between a change in lower extremity lean mass (LM) and fat mass (FM) with radiographic knee OA (RKOA) incidence in women longitudinally and concurrently. A 2-year change in LM or FM measures did not predict subsequent RKOA incidence. A 5-year increase of LM percentage was associated with a 10% reduced odds of RKOA incidence (OR 0.90, 95% CI 0.82-0.98, P=0.016]. A 0.25 unit increase in LM:FM ratio over 5 years was associated with a 31% reduced odds of RKOA incidence [OR 0.69, 95% CI 0.49-0.97, P=0.032]. Thigh muscle quality and knee extensor strength did not mediate symptomatic and functional improvements, however, a reduction in percentage whole-body fat partially mediated symptomatic and functional improvements achieved in a D+E compared to E groups. Lower extremity LM and FM changes were significantly associated with RKOA incidence concurrently, but did not precede RKOA incidence longitudinally. Further understanding of skeletal muscle properties would enable a higher treatment effect size to be achieved from rehabilitation programmes in knee OA.en_AU
dc.publisherUniversity of Sydneyen_AU
dc.publisherFaculty of Medicine and Healthen_AU
dc.publisherNorthern Clinical Schoolen_AU
dc.rightsThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
dc.subjectSkeletal Muscleen_AU
dc.subjectKnee Osteoarthritisen_AU
dc.subjectKnee Osteoarthritis Incidenceen_AU
dc.subjectKnee Osteoarthritis Progressionen_AU
dc.subject.otherincludes published articlesen_AU
dc.titleThe Role of Skeletal Muscle in the Incidence and Progression of Knee Osteoarthritisen_AU
dc.typeMasters Thesisen_AU
dc.type.pubtypeMaster of Philosophy M.Philen_AU
dc.description.disclaimerAccess is restricted to staff and students of the University of Sydney . UniKey credentials are required. Non university access may be obtained by visiting the University of Sydney Library.en_AU
dc.description.embargo2020-01-09


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