Smithfield Herald

Johnston remains a center of arthritis research

Yvonne Golightly, a physical therapist and researcher, demonstrates how to measure the arch of a foot, a procedure used in one of the studies within the Johnston County Osteoarthritis Project.
Yvonne Golightly, a physical therapist and researcher, demonstrates how to measure the arch of a foot, a procedure used in one of the studies within the Johnston County Osteoarthritis Project.

A long-term scientific study in Johnston County is continuing to pay off.

The National Institutes of Health recently awarded $5.6 million to UNC-Chapel Hill’s Thurston Arthritis Research Center for multiple projects, including another study using the Johnston County Osteoarthritis Project.

Launched in 1991, the Johnston County Osteoarthritis Project tracks people in six towns: Benson, Clayton, Kenly, Princeton, Selma and Smithfield. The study began with about 3,200 participants, but the number fell as people died or moved away. After some additions, the study is now following about 2,000 people.

The project is studying osteoarthritis, the most common type of arthritis, said Joanne Jordan, director of the project and the new grant. Osteoarthritis can cause joint pain, stiffness and loss of flexibility. Of America’s 50 million arthritis sufferers, 27 million have osteoarthritis. In Johnston County, the project found that over the course of a lifetime, about 50 percent of people develop osteoarthritis in the knee, and 25 percent develop it in the hip.

Jordan said the study is one of the few of its kind, examining the risk factors for osteoarthritis in whites, blacks, men and women in rural communities. Original participants did not necessarily have osteoarthritis – the project has actually tracked individuals as they developed the disease. More than 30 studies have used data from the long-term project, Jordan said.

The $5.6 million grant will fund a new study that will use 240 people from the arthritis project and their spouses. Led by Dr. Christine Rini, the study will look at people who already have osteoarthritis in the hip or knee and don’t get enough exercise, Rini said.

The goal of the study is to get the spouses of arthritis sufferers to encourage them to exercise. “We want them to be able to manage their pain and be healthier, and we want their partners to be able to provide support that will help them make these long-term changes,” she said.

Another goal is to eventually be able to screen for people who are not getting enough exercise and then screen to see whether their spouses would be supportive in a lifestyle change. If not, doctors would then provide more training to the spouse to help make the two a team.

“The idea here is that if you have to make a long-term lifestyle change, your partner is really well-positioned to help you, if you have the right skills to get support from them and they have the right skills to give it to you,” Rini said.

Researchers have already used the Johnston County Osteoarthritis Project to show that blacks are at risk for developing hip and knee osteoarthritis. Previously, the scientific community thought blacks had little to no risk of developing the disease in the hip. The study was also the first to determine how likely a person is to develop osteoarthritis during the course of his life, Jordan said. By age 85, almost half of Americans will develop knee osteoarthritis, and the disease is much more likely in those who are obese or have injured their knee.

Because the project has been tracking participants for more than two decades, it has also become a research ground for other diseases, including diabetes and heart disease, Jordan said. “The beauty of the study is we’ve been now following people for over 20 years,” she said.

Participants receive medical tests about every five years and also provide urine and blood samples. These are kept indefinitely at UNC-Chapel Hill, said Janice Woodard, director of the project’s Johnston County office and clinic.

As technology advances, the blood samples could yield more information, Woodard said. “You just don’t know what’s going to be there in the future,” she said.

Woodard said retention is high in the long-term project, and participants are invested. Some people who move away even travel back for the tests. The project’s staff sends participants yearly updates on what the project has helped the scientific community learn.

Woodard said the project is invaluable to researchers, especially because of how long it has gone on. “It’s hard to get funding nowadays,” she said. “They wouldn’t be able to do it again.”