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Self-efficacy is the belief that one can perform a specific behavior or task in the future, and it has been associated with physical and psychological aspects in people with chronic musculoskeletal disorders. The self-efficacy of individuals with arthritis can be assessed using the Arthritis Self-Efficacy Scale. The 8-item Short-Form ASES (ASES-8) has been employed in recent times. However, the reliability and validity of the Japanese ASES-8 (ASES-8J) have not been investigated. Therefore, this study aimed to investigate the reliability and validity of the ASES-8J. Overall, 179 Japanese participants with knee osteoarthritis (OA) were enrolled. Cronbach's alpha was calculated to confirm internal validity. Intraclass correlation coefficients (ICCs) were used to estimate test-retest reliability. Construct validity was analyzed using the Pain Self-Efficacy Questionnaire (PSEQ) and the problem-solving and positive thinking subscales of Brief Coping Orientation to Problems Experienced (Brief COPE). Discriminant validity was analyzed by comparing "worse" and "better" groups based on pain severity; short-form version of Depression, Anxiety, and Stress Scale-21 (DASS-21); Brief Fear of Movement Scale for Osteoarthritis (BFOMSO); Pain Catastrophizing Scale (PCS); and physical function subscale of Western Ontario and McMaster Arthritis Index. Cronbach's alpha and ICC were 0.94 and 0.81, respectively. Correlation coefficients among ASES-8J, PSEQ, and Brief COPE problem-solving and positive thinking subscales were 0.42, 0.43, and 0.32, respectively. Regarding the depression and stress subscales of DASS-21, BFOMSO, and PCS, the worse group showed significantly lower ASES-8J scores than the better group. Coefficients of correlation among ASES-8J, PSEQ, and the problem-solving and positive thinking subscales of Brief COPE were low to moderate. These findings suggest that the ASES-8J is a valid and reliable tool for assessing self-efficacy in Japanese patients with knee OA and can facilitate comparisons of arthritis self-efficacy between Japanese patients and non-Japanese patients. [ABSTRACT FROM AUTHOR]

Introduction: Subjective knee stiffness is a common symptom in patients with knee osteoarthritis treated conservatively. However, the influencing factors or effects of knee joint stiffness are unknown. The aim of this study was to explore the factors associated with subjective knee stiffness in patients with knee osteoarthritis. Methods: The MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PEDro databases were searched in November 2021. Prospective or retrospective cohort studies were included. The methodological quality of the selected articles was assessed using the Scottish Intercollegiate Guidelines Network checklist. Results: Twenty out of 1943 screened articles were included in this systematic review. Eighteen and two studies were rated as having acceptable and low quality, respectively. All the included studies measured subjective knee stiffness using the Western Ontario and McMaster Universities Osteoarthritis Index. The main findings were that worse preoperative subjective knee stiffness was associated with worse pain, subjective knee stiffness, and patient satisfaction at 1 year after total knee arthroplasty. In addition, worse subjective knee stiffness was associated with future degenerative changes in the knee joint, such as joint space narrowing and osteophyte growth progression. Conclusion: Subjective knee stiffness may be associated with the prognosis after total knee arthroplasty and degenerative changes in the knee joint. Early detection and treatment of knee stiffness could lead to a good prognosis after total knee arthroplasty and prevent the progression of degenerative changes in the knee joint. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate differences in psychological characteristics between people with knee osteoarthritis (OA) from Japan and Australia. Sixty-two adults from Japan and 168 adults from Australia aged over 50 years with knee pain were included. Japanese data were collected from patients with knee OA diagnosed by medical doctors. Australian data were baseline data from a randomized controlled trial. Participants were not exercising regularly or receiving physiotherapy at the time. Psychological characteristics evaluated were depressive symptoms, fear of movement, and pain catastrophizing. These psychological characteristics were compared between the Japanese and Australian cohorts by calculating 95% confidence intervals (CIs) for difference of the mean. To test for equivalence, an equivalence margin was set at 0.5 standard deviations (SD) of the mean, where these SDs were based on the Australian data. When the 95%CI for the difference of the mean value lay entirely within the range of equivalence margin (i.e. between -0.5 and 0.5 times the Australian SD), the outcome was considered equivalent. There were no differences between the groups from Japan and Australia for depressive symptoms and the two groups were considered equivalent. There was no difference between groups for fear of movement, however the criteria for equivalence was not met. People from Japan with knee OA had higher scores for pain catastrophizing than people from Australia. The findings should be confirmed in other samples of people with knee OA from Japan and Australia due to the limitations of the participant recruitment strategy in this study. However, our findings suggest there may be a greater need to consider pain catastrophizing and build pain self-efficacy when managing Japanese people with knee OA. Implementation of international clinical practice guidelines for OA management may require different strategies in different countries due to different psychological profiles. [ABSTRACT FROM AUTHOR]

We evaluated the relationship between altered foot function and knee osteoarthritis through a specific comparison of toe grip strength in older women with and without knee osteoarthritis. Participants were 120 women with knee osteoarthritis (OA group) and 108 healthy community-dwelling women with no history of knee pain and lower limb surgery (control group). The following factors and outcome variables were included in our analysis: measured toe grip strength, isometric knee extension strength, the timed Up-and-Go, and the WOMAC scale. Between-group differences were compared using unpaired t-tests for descriptive characteristics and outcome measures. Pearson’s correlation coefficients between toe grip strength and age, body mass index, and other outcome measures were calculated. Multiple logistic regression analysis was used to evaluate the independence of toe grip strength and knee osteoarthritis. Compared to the control group, participants in the OA group were older, heavier, and had a higher body mass index. Toe grip strength and isometric knee extension strength were lower and the timed Up-and-Go longer for the OA group than the control group. Toe grip strength was correlated with age negatively and isometric knee extension strength positively in the OA group and to age and the timed Up-and-Go negatively, and isometric knee extension strength positively in the control group. Multiple logistic regression analysis revealed that body mass index, isometric knee extensor strength, and toe grip strength were independently associated with knee osteoarthritis. Our findings indicate a probable association between altered forefoot function and the incidence or progression of knee osteoarthritis. Increasing toe grip strength might provide a practical intervention for patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical impact in knee osteoarthritis (OA) of coexisting patellofemoral (PF) joint OA (PFOA) in Japanese patients with medial tibiofemoral (TF) joint OA (TFOA).Methods: Patients with medial knee OA (n = 143) were enrolled. The radiographic severity of the TF and PF joints, anatomic axis angle of the TF joint, patellar alignment, trochlear morphology, patellar height, and passive range of motion (ROM) of the painful knee were evaluated. Additionally, the Japanese Knee Osteoarthritis Measure (JKOM) was used to investigate the association between the presence of PFOA and clinical symptoms.Results: PFOA was present in 98 of 143 patients (68.5%) with medial knee OA. Quantile regression analysis revealed that coexisting PFOA was associated with the pain-related subcategory of the JKOM. Furthermore, multiple logistic regression analysis showed that coexisting PFOA was associated with higher odds of reporting knee pain on using stairs while ascending (odds ratio [OR] 4.81 [95% confidence interval (95% CI) 1.73, 14.3]) and descending (OR 3.86 [95% CI 1.44, 10.8]). A more varus knee alignment and lower knee flexion ROM, which are features of patients with coexisting PFOA, were associated with knee pain while ascending/descending stairs. However, patellar alignment, trochlear morphology, and patellar height were not significantly associated with knee pain.Conclusion: PFOA coexisting with medial knee OA was associated with worse clinical symptoms, particularly while ascending/descending stairs, although patellar alignment did not contribute to reporting knee pain. Further studies that include evaluation of the PF joint are warranted to develop a basis for an optimal intervention based on compartmental involvement. [ABSTRACT FROM AUTHOR]

Background: The associations between toe grip strength (TGS) and foot structure are not well known, although foot structure is inferred to affect TGS. This study investigated the associations between TGS and hallux valgus angle (HVA), toe curl ability, and foot arch height (FAH). Methods: This study analysed 227, 20 to 79-year-old, community-dwelling participants. TGS, HVA formed by the first metatarsal bone and the proximal phalanx of the hallux, toe curl ability (percentage) calculated as (foot length-flexed foot length)/foot length, and FAH (percentage) calculated as navicular height/truncated foot length were measured. To elucidate associations between TGS and foot structure, a correlation analysis and stepwise multivariate linear regression analyses were performed, based on the participant's sex. Pearson's correlation coefficients for TGS with age, height, weight, HVA, toe curl ability, and FAH were also calculated. In the stepwise, multivariate linear regression analyses, the independent variable was TGS and the dependent variables were those that significantly correlated with TGS, as shown by the Pearson's correlation coefficients. The significance level was set at 5%. Results: According to the Pearson's correlation coefficients, in men, TGS was significantly correlated with age, height, toe curl ability, and FAH. According to the stepwise multiple regression analysis, TGS correlated with age and toe curl ability (adjusted R²=0.22). In women, TGS was significantly correlated with age, height, and toe curl ability (adjusted R²=0.40). Conclusions: TGS was associated with toe curl ability in both men and women. However, TGS was not associated with HVA and FAH in men or women. The results of this study may lead to the development of effective interventions to improve TGS. However, factors other than structure of the foot require more detailed investigation to clarify the factors contributing to TGS. [ABSTRACT FROM AUTHOR]

Background No standardised method has been adopted for measuring toe-grip strength (TGS), and no reference values have been established for evaluating it. The present study investigated agerelated changes in TGS and the association of TGS with various descriptive characteristics. Methods TGS was measured in both feet of 1842 community-dwelling individuals aged 20-79 years using a toe-grip dynamometer. The participants were classified by decade into six age groups: 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years. Correlations for TGS between the dominant and non-dominant sides were analysed according to decade and sex using Pearson's correlation coefficient. The mean TGS and TGS-to-weight ratio (TGS/Wt%) were compared between sexes by each decade and among all decades by sex using two-way analysis of variance with post-hoc tests. To assess relationships between mean TGS and various descriptive characteristics, we determined Pearson's correlation coefficient by sex and performed a stepwise multiple-regression analysis. Significance was set at 5%. Results Correlations for TGS between the dominant and non-dominant sides were significant in all decades by sex, ranging from 0.73 for men in their 70s to 0.91 for women in their 50s. Mean TGS and TGS/Wt% significantly differed between the sexes in all decades and in all decades except the 40s, respectively. In men, the mean TGS and TGS/Wt% significantly decreased with aging after the 50s and 60s, respectively. In women, both the mean TGS and TGS/Wt% significantly decreased between the 40s and 50s and between the 60s and 70s. TGS significantly correlated with age, height, and weight in both sexes. The stepwise multipleregression analysis revealed TGS was significantly associated with sex, age, height, and weight (adjusted R² = 0.31). Conclusions TGS was closely correlated between the dominant and non-dominant sides. TGS and TGS/Wt were significantly reduced with aging after the 50s in men and significantly reduced between the 40s and 50s and between the 60s and 70s in women. Age, sex, height, and weight accounted for only 30.8% of the variance in TGS. Therefore, other factors (e.g. toe flexibility, structural characteristics) should be considered for improving the accuracy of predicting TGS. [ABSTRACT FROM AUTHOR]

[Purpose] We examined the relationships between subjective masticatory ability and indices related to metabolic syndrome for specific health check-up participants. [Subjects] The subjects were 56 specific health checkup participants. [Method] We compared the results of anthropometric measurements, blood tests, bite strength, and a questionnaire on eating habits with good and poor subjective masticatory ability. [Results] Bite strength was significantly higher in the good group, and in the comparison of the blood tests, HbA1c was significantly lower in the good group. With regard to the questionnaire, the good group took longer over lunch, ate meals slowly, and had a tendency to avoid light meals. [Conclusion] Those with good subjective masticatory ability took care over the speed and content of meals, and had a strong bite. The results also suggest a relationship between subjective masticatory ability and HbA1c. [ABSTRACT FROM AUTHOR]

[Purpose] The effect of temporomandibular disorder (TMD) symptoms on mouth opening in two head positions was examined. [Subjects] The subjects were 22 adults who were not receiving dental treatment. [Method] In upright sitting (UP) and in forward head posture (FHP), in maximal mouth opening, range of mouth opening and left and right mandibular head movement distance were compared between TMD and no TMD subjects. [Results] For the two groups of subjects, there were no significant differences in range of mouth opening, and left and right mandibular head movement distance between head positions. For the no TMD group, in the UP position, significant positive correlations were seen between left and right mandibular head movement distance, and between range of mouth opening and both left and right mandibular head movement distance; and in the FHP position, significant positive correlations were found between left and right mandibular head movement distance, and between range of mouth opening and left mandibular head movement distance. For the TMD group the same relationships were found only in the UP position; no significant relationships were found in the FHP position. [Conclusion] The results suggest the possibility that coordinated movements of the jaw are easily disturbed by head position in subjects having TMD symptoms. [ABSTRACT FROM AUTHOR]

[Purpose] We investigated the effect of exercise intervention and nutrition management on an arterial stiffness related index and physical function in stroke patients. [Subjects] Subjects were sixteen community-living stroke patients. [Methods] Exercise intervention that consisted of a two-hour program was performed twice a week for three months. Nutrition management was performed by nutrition managers during the intervention. We measured the Cardio-Ankle Vascular Index (CAVI), and the Ankle-Brachial Index (ABI) to assess the arterial function. Other measurements included gait speed, grip strength, Functional Reach Test (FRT), Timed Up and Go Test (TUG), and Sit-to-stand Test. [Results] In arterial function, CAVI of the affected side was significantly improved after intervention. There was no significant difference in ABI. In physical function, FRT and TUG were significantly improved. [Conclusion] These results suggest that an interdisciplinary intervention consisting of exercise and nutrition management was effective at not only improving physical function but also arterial function. [ABSTRACT FROM AUTHOR]

[Purpose] This study investigated the effect of floating toes on knee and trunk acceleration during walking in experimental setting. [Subjects and Methods] Twelve healthy volunteers walked barefoot at a preferred speed along a linear pathway under 2 conditions: normal gait (control) condition and floating toes (FT) condition. In the latter, weight bearing by the toes was avoided using kinesiology tape applied along the toe extensors. Accelerations of the knee (Kn) and lumbar spine (Lx) were assessed using triaxial accelerometers mounted on the right fibular head and the spinous process of L3. Acceleration vectors were oriented such that the anterior, right, and cranial deviations were positive along the anteroposterior, lateral, and vertical axes, respectively. The root mean squares (RMSs; anteroposterior, RMSap; lateral, RMSl; vertical, RMSv) were calculated, and the mean values of 3 trials in each condition were determined. Differences between the conditions were assessed using the Wilcoxon signed-rank test. [Results] LxRMSap and LxRMSv were larger in the FT condition than in the control condition. KnRMSv tended to be higher in the FT condition than in the control condition. [Conclusion] Floating toes increase acceleration and might create mechanical stress on the lower back and knee during walking.

Evaluating toe flexor strength may be an important method for predicting and preventing walking dysfunction and falls, particularly among older adults. In this study, toe grip strength (TGS), the functional reach (FR, a measure of dynamic balance) test, the timed up and go (TUG) test (a measure of functional ability), isometric knee extension strength (IKES), sex, age, weight, and height were analyzed among 665 healthy Japanese older adults. Statistical analyses were used to assess the relationships between TGS and FR or TUG and to investigate whether TGS was independently associated with FR or TUG. Our results indicate that, among both men and women, TGS was associated with TUG, independent of age, height, weight, and IKES, but TGS was not associated with FR. These results may facilitate the development of strategies for improving functional mobility through physical therapy.

Background: Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA)., Objective: The aim of this study was to investigate the association between varus thrust and 2 subcategories-"pain and stiffness" and "activities of daily living (ADL)"-of the Japanese Knee Osteoarthritis Measure (JKOM)., Design: This was a cross-sectional study., Methods: In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed., Results: Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis., Limitations: Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study., Conclusions: Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance., (© 2016 American Physical Therapy Association.)

[Purpose] This study investigated the relationship between toe grip strength and foot posture in children. [Subjects and Methods] A total of 619 children participated in this study. The foot posture of the participants was measured using a foot printer and toe grip strength was measured using a toe grip dynamometer. Children were classified into 3 groups; flatfoot, normal, and high arch, according to Staheli's arch index. The differences in demographic data and toe grip strength among each foot posture group were analyzed by analysis of variance. Additionally, toe grip strength differences were analyzed by analysis of covariance, adjusted to body mass index, age, and gender. [Results] The number of participants classified as flatfoot, normal, and high arch were 110 (17.8%), 468 (75.6%), and 41 (6.6%), respectively. The toe grip strength of flatfoot children was significantly lower than in normal children, as shown by both analysis of variance and analysis of covariance. [Conclusion] A significant difference was detected in toe grip strength between the low arch and normal foot groups. Therefore, it is suggested that training to increase toe grip strength during childhood may prevent the formation of flat feet or help in the development of arch.

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.

[Purpose] The aim of this study was to evaluate the reliability of upper quadrant posture analysis using an ultrasound-based three-dimensional motion analyzer. [Subjects] Subjects were 72 healthy young adults. [Methods] Neck inclination angle formed by a line connecting C7 and the tragus with a horizontal line, angle of the shoulder formed by a line connecting C7 and the acromial angle with a horizontal line, and cranial rotation angle formed by a line connecting the tragus and corner of the eye with a horizontal line were measured using an ultrasound-based three-dimensional motion analyzer. Intra- and inter-rater reliabilities of two testers, standard error of measurements, minimal detectable change at the 95% confidence level, and systematic bias were evaluated. [Results] Intra-class correlation coefficients (1,1) were 0.65 to 0.82. Intra-class correlation coefficients (2,1) were 0.76 to 0.82. High measurement error was found in the cranial rotation angle. Fixed bias was found for the angle of the shoulder in the inter-rater reliability. [Conclusion] Posture analysis using an ultrasound-based three-dimensional motion analyzer appears useful for assessing neck inclination angle and the angle of the shoulder in individuals, and cranial rotation angle in patient groups.