Background: Pain neuroscience education (PNE) has been shown to reduce pain or psychological symptoms in patients with chronic pain and preoperative knee osteoarthritis; however, the evidence of its effectiveness in hospitalized patients who have undergone high tibial osteotomy (HTO) is unknown. This study was performed to determine whether the implementation of a newly developed hospital-time PNE provided by physical therapists to patients after HTO can result in meaningful improvements. Methods: In total, 119 patients aged ≥45 years with knee osteoarthritis who were scheduled to undergo HTO were analyzed. Patients with a low Pain Catastrophizing Scale (PCS) score of < 21 were excluded. The patients were classified into two groups: those who underwent a combination of PNE and rehabilitation (intervention group, n = 67) and those who underwent rehabilitation only (control group, n = 52). The patients were pseudo-randomized by their baseline demographic factors using a propensity score-matching method. The PNE was based on a psychosocial model and began 1 week postoperatively in a group setting; five 1-h weekly sessions were conducted. The primary outcome was the walking pain score as measured by a numerical rating scale. The secondary outcomes were the pain catastrophizing scores as measured by the PCS, self-efficacy as measured by the Pain Self-Efficacy Questionnaire, and physical function. Measurements were taken at baseline (before surgery) and before discharge from the hospital (5 weeks postoperatively) to identify any intervention effects. Results: After propensity score matching, 52 pairs of patients were extracted. In the intervention group, 46 (88.5%) patients completed the PNE. In total, 44 patients in the intervention group and 52 patients in the control group were analyzed. Five weeks following surgery, the rehabilitation itself had also significantly decreased catastrophizing, and the difference between the two groups had only a small effect size (d = 0.44). Conclusions: These findings provide preliminary evidence that physical therapist-delivered PNE during hospitalization may help to at least slightly reduce pain catastrophizing in patients with catastrophizing prior to knee arthroplasty. Trial registration: This trial was retrospectively registered with ClinicalTrials.gov (UMIN000037114) on 19 June 2019.

Passive sedentary behavior (SB) may lead to adverse health outcomes; however, it remains unclear whether the factors relevant to passive SB differ between older adults with and without knee osteoarthritis (KOA). This cross-sectional study examined factors associated with passive SB among 688 community-dwelling older women with (n = 128) and without (n = 560) KOA. Passive SB (min/day) was assessed using the Japanese-translated version of the Measure of Older Adults’ Sedentary Time questionnaire. Demographic, lifestyle, and psychosocial factors; pain; and physical performance were evaluated in multiple regression models with an interaction term concerning SB between the two groups. The mean (SD) total SB for those without and with KOA was 490.4 (200.9) min/day and 487.4 (185.8) min/day, respectively, and the majority of SB was passive, with no difference between groups. Passive SB was associated with an obese status and less time spent in group activities. However, no KOA-specific SB factors were identified. Therefore, effective interventions to promote social participation and weight loss, especially for individuals with obesity, may reduce passive SB, regardless of KOA. Longitudinal studies are warranted to identify causal relationships.

Background: Wearable Internet of Things (IoT) devices are powerful tools for remotely collecting intensive longitudinal data. The TDK Silmee W22, a wristband-type wearable IoT device with a built-in 3-axis acceleration sensor, provides minute-by-minute physical activity data such as estimated metabolic equivalents (METs) and step counts. These measurements can be aggregated to daily estimates; however, their accuracies have not been fully explored in adults under free-living settings. Objective: This study aims to assess the agreement between the TDK Silmee W22 and the research-grade activity monitor, ActiGraph wGT3X-BT, in estimating daily steps and time spent in moderate to vigorous physical activity (MVPA ≥3 METs) in adults under free-living settings. Methods: A convenience sample of young to older adults was recruited from communities across several prefectures in Japan. Participants concurrently wore a TDK Silmee W22 on their nondominant wrist and an ActiGraph wGT3X-BT on the left side of the waist during waking hours for 7 consecutive days. Data were aggregated to daily steps and time spent in MVPA (≥1952 vertical axis counts/minute for ActiGraph) for each participant. A valid day was defined as having ≥ 10 hours of accumulated ActiGraph wear time with ≥100 and <50,000 accumulated steps from both devices. Each valid day was classified as either an active day (≥10,000 steps/day or ≥21.4 minutes MVPA per day) or an inactive day. Bland-Altman plots combined with multilevel analysis and κ statistics were used to assess the agreement between physical activity estimates from the devices. Results: A total of 129 participants (n=66, 51.2% women) aged 23‐89 years provided the final dataset of 884 observations (5 to 7 daily observations/participant). The TDK Silmee W22 estimated an overall mean of 6369 (SE 242) steps/day and 40.3 (SE 1.9) minutes/day spent in MVPA. Although Bland-Altman plots suggested no obvious proportional bias, fixed biases were observed; the TDK Silmee W22 estimated −1203 steps/day (95% limits of agreement [LoA] −4202 to 1796) and +5 minutes/day (LoA−23 to 34) spent in MVPA compared with those estimated by the ActiGraph wGT3X-BT. TDK Silmee W22 and ActiGraph wGT3X-BT, respectively, classified 14% and 23.1% as active by daily step counts (κ=0.65, 95% CI 0.59‐0.72), and 70.4% and 60.9% as active by daily time spent in MVPA (κ=0.64, 95% CI 0.59‐0.69), both indicating moderate agreement. Conclusions: TDK Silmee W22 underestimated step counts and overestimated time spent in MVPA compared with the research-grade ActiGraph wGT3X-BT, which may lead to misclassification of active and inactive days. Caution is warranted when using TDK Silmee W22 data over relatively short periods, as discrepancies—particularly when compared with research-grade monitors—may affect feedback or goal setting.

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