The FIT Core research study at the Indiana University School of Medicine is part of a larger effort to make IU a world leader in musculoskeletal health and innovation. By volunteering for the study, senior writer Laura Gates learned about her own risk for osteoporosis while contributing to scientific understanding of musculoskeletal diseases.
I’m walking in a loop down a lonely hospital corridor. Back and forth at a brisk pace. Six minutes starts to feel like much longer.
I’m not pacing the halls because a loved one is hospitalized. I’m doing a physical function test. The precisely spaced cones laid out in a low-traffic hallway at IU Health University Hospital indicate that one more participant is joining the FIT Core study.
Today that one is me.
The results of my physical function testing, along with information from a head-to-toe body scan called DXA, will join a massive dataset housed at the Indiana University School of Medicine and used by medical scientists at IU and beyond. It’s part of IU’s larger goal to help Indiana become a world leader in musculoskeletal innovation.
Since the 2017 start of the Musculoskeletal Functioning, Imaging and Testing Resource Core, or FIT Core — sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and part of the Indiana Center for Musculoskeletal Health — about 5,300 people have joined the study. Some, like me, are healthy volunteers who are curious about their risk for osteoporosis. Others are invited to participate because they are living with a disease, and researchers want to know how that disease affects their bones and muscles — and their functioning in everyday life.
“Data produced in the FIT Core can be used by clinicians and researchers to better understand the functional consequences of various illnesses and, hopefully, lead to interventions that produce better patient outcomes,” explained Stuart Warden, PhD, director of the FIT Core.
One among thousands: How FIT Core accelerates research
At the end of my FIT Core testing, I am rewarded with an enlightening seven-page printout comparing my personal body scan and testing metrics against what’s “normal” for my age and sex. But the real value of my two-hour testing commitment is that my personal data will be de-identified and added to a massive dataset that is accelerating discovery.
To date, more than 200 scientific investigators at IU, Purdue University and elsewhere have used the FIT Core to further their research. Kenneth Lim, MD, PhD, is among them. An award-winning physician scientist and nephrologist, Lim runs a first-of-its-kind cardiopulmonary exercise testing (CPET) lab at IU, dedicated exclusively to improving the health of patients with kidney disease.
Lim’s CPET lab shares a space with the FIT Core’s dual energy X-ray absorptiometry (DXA) scanner. Nearly every patient who participates in his team’s kidney disease research also signs up for FIT Core; about 200 people have completed both sets of function tests as part of clinical trials run by Lim.
“The CPET machine gives us one set of information, and the FIT Core gives us another set of information — they’re very complementary,” he said. “What we get is this really amazing set of comprehensive assessments that give us a very good picture of what’s going on in the organs that are essential for exercise and physical function.”
With about 30 research projects simultaneously underway in the Lim lab, this data helps his scientific team understand various aspects of how kidney disease impacts a person’s heart, muscles and bones.
“We’re also asking the question, ‘Can we actually reverse some of these disorders through the drugs that we’re testing?’” added Lim. One of his current clinical trials is exploring whether a class of drugs that is FDA-approved for diabetes could also be used to improve physical function in kidney patients.
With about 1 in 7 people in the United States living with kidney disease, any advancement in treatment could improve the lives of more than 37 million people.
Beyond kidney disease, other investigators are using the FIT Core to conduct research on patients with liver disease, cystic fibrosis, heart failure, migraines, diabetes, Ehlers-Danlos syndrome, rare bone diseases, ovarian cancer and breast cancer, to name a few.
“The collection of a breadth of data from a large cohort of individuals that is linked with blood samples and the individual's electronic health record is unique,” Warden said. “It expedites the answering of unique research questions and brings together researchers from different fields, each with their own individual expertise.”
Furthering his own research interests in musculoskeletal health, Warden has used FIT Core data in about 24 scholarly papers, primarily to define what “normal” looks like among various populations.
“The big benefit of comparing the physical abilities and bone health of individuals with various disease conditions to the reference data is that we can see how their condition impacts them without having to recruit, match and test a separate group of healthy individuals,” he explained. “We already know what ‘normal’ is.”
Back to one: What FIT Core means to me
On the day of my FIT Core testing, I change from business casual into a T-shirt, leggings and jogging shoes. When I arrive, I’m greeted by research coordinator Patrick Johnson, who has been with the FIT Core since its beginning back in 2017.
He asks me to sign the consent form and introduces me to Audrey Fried, another research coordinator who will put me through a series of physical tests, including balance tests, walking speed measurements, a hand-grip strength test and some timed tests, like seeing how many times I can go from sitting to standing in 30 seconds.
Johnson handles the blood draws (or saliva tests for minors) and runs the imaging scans. Tissue samples allow researchers to see how genetics might affect musculoskeletal health. Although the study information is linked to a person’s electronic health record, I am assured that researchers will never see my personal information.
After my physical tests, it’s time for my DXA scan, which is so low in radiation that Johnson sits nearby without needing any protective gear. As I lie on the slowly moving table, the scanner efficiently measures my body composition and bone mineral density.
Nearly 1 in 5 women and 1 in 20 men over the age of 50 are affected by osteoporosis, which increases risk for broken bones. When the FIT Core was just launching, Warden said he hoped study participants would view their personal data as motivation for making healthy changes in their daily lives.
For me, it has done just that. While my physical performance scores are slightly better than average for a woman my age, the DXA scan reveals I am at risk of developing osteoporosis. When I’m back home, I ask an AI assistant to create a strength training regimen that I can easily incorporate into my daily routines.
Wanted: Kids and older adults
Although my particular demographic is already well represented in the FIT Core, I hope that sharing my experience might inspire others to participate who represent populations that are still needed: children ages 5-17, people over 70, and individuals from minority racial or ethnic groups.
“The FIT Core has a lot of data from individuals ages 18-75, and particularly white women,” Warden said. “In order to be able to determine what ‘normal’ is in other demographics, we need to test a lot more people in those demographics.”
The FIT Core team has developed a website where potential participants can learn more about the study, or they may call to make an appointment: 317-278-3333.
More about FIT Core (just for researchers)
Investigators who are interested in using FIT Core resources in their clinical research can find out more about the core’s menu of services and learn about other resources on the Indiana Center for Musculoskeletal Health website.
The resources provided by the FIT Core are free for IU investigators to use.
“Our mission is essentially to mitigate some of the upfront parts of establishing a research study,” explained Cody Altherr, the program’s navigator. “As a service core, we help provide these resources for investigators, so they can focus on their science.”
