February 1999 Bulletin
Academy urges women's health research
Testimony in yearbook recommends areas of study of musculoskeletal
Academy testimony about advances made in women's health research
over the past year is included in the Society for the Advancement
of Women's Health Research Yearbook.
The yearbook will be distributed to policy makers, opinion leaders
and private industry. It will also serve as the Society's basis
for planning educational efforts such as briefings, public relations,
and public and professional outreach programs. The society is
a private, non-profit organizations established in 1990. It's
three strategic priorities are to promote the study and acceptance
of gender-based biology in the scientific community, to enhance
the recruitment and retention of women in clinical trials and
to increase research funding for women's health research.
The testimony was prepared by Laura L. Tosi, MD, and Rebecca R.
Schwaab, policy analyst in the Academy's department of research
and scientific affairs.
Dr. Tosi said offering testimony of this nature is one way the
Academy can aid in the fight for more research funding to be directed
to musculoskeletal research. "Every testimony that we give
wakes people up in Washington," said Dr. Tosi.
While the testimony highlights advances in treatment and management
of arthritis, osteoporosis, sports injuries and upper extremity
musculoskeltal problems, it also provides recommendations for
research to help medical professionals further understand these
four health problems.
The recommendations include:
- further research to better understand why arthritis is more
common in women, what triggers it, the role that risk factors
play in the progression of the conditions and the different gender
patterns in some diseases.
- research to explore the biological and mechanical factors
that influence the progression of osteoarthritis and address the
possible early biological repair process in osteoarthritis with
attention to the role of growth factors, among others, that would
prevent late changes that lead to joint replacement.
- prospective clinical trials for various surgical procedures
designed to stimulate repair of osteoarthritic joints and outcomes
studies of these procedures.
- life-long prospective studies to determine the effects of
childhood calcium intake on peak bone mass.
- increasing awareness of and education about the triad of osteoporosis,
eating disorders and amenorrhea found in young female athletes.
- developing a better understanding of the effects of drugs
that stabilize bone mass and a better understanding of the different
forms of osteoporosis, their courses of progression and the impact
of types of treatment programs.
- addressing the questions of why osteoporosis is more common
in the female Caucasian and Asian populations, what triggers it
and the role that risk factors play in its progression.
- developing a better understanding of the role of falls in
- research relative influences of osseous anatomy, ligamentous
laxity, and the effect of sex hormones on knee injuries and anterior
cruciate ligament (ACL) injuries, spondylolisthesis, stress fractures
in the pelvis and hip, pelvic floor dysfunction, patellofemoral
problems, and bunions to help develop an understanding of why
injury patterns differ between men and women.
- further research on devices and surgical technique improvements
to enhance patient care and facilitate an earlier return to function.
- developing a better understanding of molecular signals that
control repair and growth function in cells of the musculoskeletal
- developing synthetic replacements for muscle, soft tissue
and bone damaged beyond repair, and enhancing the ability to manipulate
the body's immune system to increase successful transplantation
of donated bone and ligaments.
- exploring the basis for gender differences in treatment: what
is effective, why outcomes in men and women differ when receiving
the same treatment, and what mechanisms are underlying these differences.
- research on the pathophysiology of carpal tunnel syndrome
is necessary before research into the prevention of the condition
can be undertaken.
- further research of the impact of ergonomically correct workstations
and physical activity on the incidence of carpal tunnel syndrome.
- research to gain a better understanding of the basis of arthritis
of the basilar joint and prevention of the condition.
- research to determine why gender differences exist in the
prevalence of frozen shoulder syndrome.
- Research to determine who might be at risk for Colles' fracture.
The Society for the Advancement of Women's Health Research also
incorporated some of the Academy's written testimony into an oral
presentation at its scientific advisory meeting attended by national
medical and scientific experts, representatives of medical specialty
societies, policy-makers and journalists in early November.