Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial.

INTRODUCTION: Knee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients. MATERIAL AND METHODS: "Rak Kao" (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores. RESULTS: Completion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients' experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen. CONCLUSIONS: With the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03666585.

Simulation of 3D Body Shapes for Pregnant and Postpartum Women.

Several studies have reported that pre-pregnant women's body mass index (BMI) affects women's weight gain with complications during pregnancy and the postpartum weight retention. It is important to control the BMI before, during and after pregnancy. Our objectives are to develop a technique that can compute and visualize 3D body shapes of women during pregnancy and postpartum in various gestational ages, BMI, and postpartum durations. Body changes data from 98 pregnant and 83 postpartum women were collected, tracked for six months, and analyzed to create 3D model shapes. This study allows users to simulate their 3D body shapes in real-time and online, based on weight, height, and gestational age, using multiple linear regression and morphing techniques. To evaluate the results, precision tests were performed on simulated 3D pregnant and postpartum women's shapes. Additionally, a satisfaction test on the application was conducted on new 149 mothers. The accuracy of the simulation was tested on 75 pregnant and 74 postpartum volunteers in terms of relationships between statistical calculation, simulated 3D models and actual tape measurement of chest, waist, hip, and inseam. Our results can predict accurately the body proportions of pregnant and postpartum women.

Differential investment in body girths by sex: Evidence from 3D photonic scanning in a Thai cohort.

OBJECTIVES: Life history trade-offs may manifest between competing organs and tissues in the body. Sexual dimorphism in tissue investment is well-established in humans, with sex-associated body shape differences linked to natural and sexual selection. This study uses three-dimensional (3D) photonic scanning to test whether males and females differentially invest energy in various body regions in relation to two independent proxies of growth. MATERIALS AND METHODS: Body shape data (multiple girths) came from a Thai cohort (n = 11,610; 53% female; age range 21-88 years). Weight was considered a proxy for recent energy acquisition. Stature represented completed growth, a proxy for energy acquisition earlier in life. The data were analyzed using growth-proxy by sex interaction log-log regression models adjusting for age, salary and number of children. RESULTS: For a given percentage increase in weight, females showed greater percentage increases than males in girths of the arm, chest, hip, thigh, knee and calf (p < 0.001), whilst males exceeded females in head and waist girths (also p < 0.001). For a given percentage increase in height, weight and all girths showed greater proportional changes in males than females (p < 0.001). DISCUSSION: These results indicate sex-specific life history strategies wherein the direction and timing of energy investment in girths varies between the sexes. The results add to literature suggesting that sexual dimorphism in body morphology is not a fixed trait; rather, differential energy allocation to specific body regions appears to be a plastic strategy adjusted in relation to energy acquisition across the life course.

Reproduction, aging, and body shape by three-dimensional photonic scanning in Thai men and women.

OBJECTIVES: Aging and reproduction have been independently associated with body shape in women, with redistribution of body fat from lower to upper body regions. This may be interpreted as a life history strategy for allocating energy between competing peripheral fat depots for reproduction, and central fat depots for maintenance and survival. It remains unclear whether men show similar life history strategy in shape. The objectives of this study were to investigate associations between shape, age, and number of offspring in both men and women from Thailand. METHODS: We analyzed data on body shape from three-dimensional photonic scanning, and number of reported offspring, available for 5,889 men and 6,449 women aged 16-90 years from the Thai National Sizing Survey. RESULTS: Bearing children was associated with increased upper body girths and decreased lower body girths in women, independent of age, weight and height. Unlike motherhood, fatherhood was not associated with shape outcomes indexing adiposity, but was associated with arm girth, which may represent an index of sexual attractiveness. In those without children, aging was associated with greater upper body girths and reduced lower body girths, in both sexes. CONCLUSIONS: Life history strategy in body shape is apparent in both sexes, with aging associated with a shift of tissue away from the lower limb to the upper body. Such strategy may reflect age-changes in the relative costs and benefits of different regional tissue masses. Changes in fat distribution related to aging and reproduction may contribute to the life-course development of cardiovascular risk.