The effectiveness of exercise with behavior change techniques in people with knee osteoarthritis: A systematic review with meta-analysis.

OBJECTIVE: The purpose of this systematic review with meta-analysis was to examine the effectiveness of exercise with behavior change techniques (BCTs) on core outcome sets in people with knee osteoarthritis. LITERATURE SURVEY: We searched randomized controlled trials (RCTs) in eight databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO, PEDro, ICTRP, and ClinicalTrials.gov) up to November 4, 2021. METHODOLOGY: Eligible participants were people with knee osteoarthritis. The intervention was exercise with BCTs. Primary outcomes included physical function, quality of life (QOL) 6 to 12 months after intervention, and adverse events. Secondary outcomes were knee pain, exercise adherence, mobility, and self-efficacy 3 months or more after intervention. The bias risk was assessed using the Risk of Bias 2 tool. The random-effects model was used for the meta-analysis. SYNTHESIS: We found 16 individual BCTs, and 37.7% of trials used a single BCT. For meta-analysis, we included 21 RCTs (n = 1623). Most outcomes had a very low certainty of evidence, and the risk of bias was the consistent reason for downgrading evidence levels. The standardized mean difference (SMD) with 95% confidence interval (95% CI) was 0.00 (-0.24, 0.24) in physical function, 0.33 (-0.51, 1.17) in exercise adherence, and 0.04 (-0.39, 0.47) in self-efficacy. The risk ratio (95% CI) of adverse events was 3.6 (0.79, 16.45). QOL was not pooled due to insufficient data (very low certainty of evidence). In contrast, the SMD (95% CI) for knee pain reduction and mobility improvement was -0.33 (-0.53, -0.13) and 0.21 (-0.05, 0.47) with moderate and low certainty of evidence, respectively. CONCLUSION: The evidence is inconclusive regarding the effectiveness of BCTs with exercises on core outcome sets. Further research should explore the effectiveness of BCTs with valid design. PROTOCOL REGISTRATION: PROSPERO (CRD42020212904).

Gender Differences in Life-space Mobility-associated Factors and Structures in Community-dwelling Older People.

Objectives: This cross-sectional study sought to examine gender dissimilarities in factors and structures associated with life-space mobility (LSM) in community-dwelling older people. Methods: This study included a total of 294 older people living in Okawa, Fukuoka Prefecture, Japan. The subjects' body mass index (BMI) and skeletal muscle mass index (SMI) were evaluated. Furthermore, the age, gender, and LSM of the participants were assessed. LSM was assessed using a framework based on social isolation, fall self-efficacy, mobility, cognitive function, and lower limb muscle strength. Path analysis was performed to assess LSM-associated factors and their respective effect sizes (ESs), and male and female LSM models were established. Results: Path analysis identified SMI and social isolation as direct factors and cognitive function as an indirect factor associated with LSM in both men and women. In the male LSM model, the direct factors in descending order of ES were BMI, social isolation, SMI, and lower limb muscle strength. In the female model, the direct factors in descending order of ES were age, fall self-efficacy, mobility, social isolation, and SMI; age was noted as having an indirect effect on the remaining associated factors. Conclusions: This study clarified the gender differences in factors influencing LSM and the underlying structure of LSM mediation by these factors. Therefore, gender differences should be considered when planning interventions aimed at improving the LSM and general well-being of older people, particularly for community-dwelling individuals.

Relationship between single-leg stance test with light touch and hip muscle strength in healthy young adults.

[Purpose] This study investigated the relationship between the single-leg stance test with light touch and hip rotator muscle strength. [Participants and Methods] Thirty-one healthy young adults participated in the study. A single leg stance test with light touch was performed to evaluate the participants' static balance ability. The duration that an individual could successfully perform the single leg stance test with light touch in the eyes open was measured. The participants were instructed to slightly touch their right index fingertip on the digital scale. The hip muscle strength of the internal rotators and external rotators were measured by the isometric peak torque. The internal/external rotator strength ratio was calculated by dividing the strength of the internal rotator by that of the external rotator. [Results] The hip external rotator muscle strength was higher in males than in females. Moreover, there was a significant correlation between the single-leg stance test with light touch and hip external rotator muscle strength in males and between the single leg stance test with light touch and hip internal rotator muscle strength in females. Furthermore, a significant positive correlation was found between the single leg stance test with light touch and hip internal rotator/external rotator ratio in males. [Conclusion] We concluded that the single leg stance test with light touch is a useful tool to evaluate static hip muscle strength.

Particular protrusion perception arising from plantar sensory input and task guidance enhances lower limb joint dynamics during gait.

[Purpose] To assess the influence of plantar sensory input and task guidance produced by a protrusion on lower limb joint dynamics during gait by changes in muscle activity and two-dimensional motion analysis. The protrusion seals on the soles of the feet, named "Perceptual Stimulus Protrusion" were used in this study. [Participants and Methods] In this study, 40 and 42 healthy adults were recruited for muscle activity and two-dimensional analysis, respectively. In addition to walking without perceptual stimulus protrusion ("Control" condition), the testing conditions included attachment of the protrusion to the heel ("Heel Condition") and the hallucal ("Hallucal Condition"). As task guidance, participants were orally instructed how to walk for each conditions. The muscle activities of the rectus femoris, vastus medialis, tibialis anterior, and medial head of the gastrocnemius were measured. The two-dimensional analysis was compared with the angle of ankle dorsiflexion and plantarflexion, the toe height during the swing phase between the test conditions, respectively. [Results] In the Heel Condition, the tibialis anterior and vastus medialis activity in the stance and swing phases, toe height, and angle of ankle dorsiflexion and plantarflexion increased. In the Hallucal Condition, tibialis anterior activity during the stance and swing phases, gastrocnemius activity during the stance phase, toe height, and angle of ankle plantarflexion increased. [Conclusion] Plantar sensory input and task guidance using perceptual stimulus protrusion influences active motion control. Therefore, the application of this procedure can be expected to support motion guidance, such as gait and load practice.