{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:27:43Z","timestamp":1790238463184,"version":"4.1.0"},"reference-count":39,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T00:00:00Z","timestamp":1703548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["oarsiopenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Osteoarthritis and Cartilage Open"],"published-print":{"date-parts":[[2024,3]]},"DOI":"10.1016\/j.ocarto.2023.100431","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T12:02:12Z","timestamp":1704801732000},"page":"100431","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Mediators of the effects of exercise and manual therapy for people with knee and hip osteoarthritis: A secondary, exploratory analysis of the MOA trial"],"prefix":"10.1016","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9287-9187","authenticated-orcid":false,"given":"Daniel Cury","family":"Ribeiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Lamb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6468-7284","authenticated-orcid":false,"given":"J. Haxby","family":"Abbott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ocarto.2023.100431_bib1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1177\/0269215517691084","article-title":"The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs","volume":"31","author":"Brosseau","year":"2017","journal-title":"Clin. Rehabil."},{"key":"10.1016\/j.ocarto.2023.100431_bib2","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1136\/bjsports-2015-095424","article-title":"Exercise for osteoarthritis of the knee: a Cochrane systematic review","volume":"49","author":"Fransen","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib3","doi-asserted-by":"crossref","DOI":"10.1016\/j.ocarto.2020.100113","article-title":"Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: a systematic review of sub-group analyses from randomised controlled trials","volume":"2","author":"Quicke","year":"2020","journal-title":"Osteoarthritis Cartilage Open"},{"key":"10.1016\/j.ocarto.2023.100431_bib4","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1001\/archpsyc.59.10.877","article-title":"Mediators and moderators of treatment effects in randomized clinical trials","volume":"59","author":"Kraemer","year":"2002","journal-title":"Arch. Gen. Psychiatr."},{"key":"10.1016\/j.ocarto.2023.100431_bib5","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1136\/annrheumdis-2012-202745","article-title":"EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis","volume":"72","author":"Fernandes","year":"2013","journal-title":"Ann. Rheum. Dis."},{"key":"10.1016\/j.ocarto.2023.100431_bib6","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.joca.2018.01.018","article-title":"Knee extensor strength gains mediate symptom improvement in knee osteoarthritis: secondary analysis of a randomised controlled trial","volume":"26","author":"Hall","year":"2018","journal-title":"Osteoarthritis Cartilage"},{"key":"10.1016\/j.ocarto.2023.100431_bib7","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.arr.2012.09.005","article-title":"Osteoarthritis of the knee: why does exercise work? A qualitative study of the literature","volume":"12","author":"Beckwee","year":"2013","journal-title":"Ageing Res. Rev."},{"key":"10.1016\/j.ocarto.2023.100431_bib8","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/pm\/pnz187","article-title":"Pain catastrophizing and arthritis self-efficacy as mediators of sleep disturbance and osteoarthritis symptom severity","volume":"21","author":"Tighe","year":"2020","journal-title":"Pain Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib9","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.joca.2012.12.014","article-title":"Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness","volume":"21","author":"Abbott","year":"2013","journal-title":"Osteoarthritis Cartilage"},{"key":"10.1016\/j.ocarto.2023.100431_bib10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1745-6215-10-11","article-title":"Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomised controlled trial protocol","volume":"10","author":"Abbott","year":"2009","journal-title":"Trials"},{"key":"10.1016\/j.ocarto.2023.100431_bib11","series-title":"Management of Osteoarthritis: A Guide to Non-surgical Intervention","author":"Abbott","year":"2014"},{"key":"10.1016\/j.ocarto.2023.100431_bib12","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2340\/16501977-0072","article-title":"Pain belief screening instrument: development and preliminary validation of a screening instrument for disabling persistent pain","volume":"39","author":"Sandborgh","year":"2007","journal-title":"J.\u00a0Rehabil. Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib13","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1080\/09638280701523200","article-title":"The Pain Belief Screening Instrument (PBSI): predictive validity for disability status in persistent musculoskeletal pain","volume":"30","author":"Sandborgh","year":"2008","journal-title":"Disabil. Rehabil."},{"key":"10.1016\/j.ocarto.2023.100431_bib14","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/02701367.1999.10608028","article-title":"A\u00a030-s chair-stand test as a measure of lower body strength in community-residing older adults","volume":"70","author":"Jones","year":"1999","journal-title":"Res. Q. Exerc. Sport"},{"key":"10.1016\/j.ocarto.2023.100431_bib15","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1007\/s11121-014-0528-5","article-title":"Sample size for joint testing of indirect effects","volume":"16","author":"Vittinghoff","year":"2015","journal-title":"Prev. Sci."},{"key":"10.1016\/j.ocarto.2023.100431_bib16","first-page":"39","article-title":"Causal survival analysis: a guide to estimating intention-to-treat and per-protocol effects from randomized clinical trials with non-adherence","volume":"2","author":"Murray","year":"2021","journal-title":"Res. Methods Med. Health Sci."},{"key":"10.1016\/j.ocarto.2023.100431_bib17","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1056\/NEJMsm1605385","article-title":"Per-protocol analyses of pragmatic trials","volume":"377","author":"Hernan","year":"2017","journal-title":"N.\u00a0Engl. J. Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib18","doi-asserted-by":"crossref","first-page":"560","DOI":"10.7326\/0003-4819-159-8-201310150-00709","article-title":"Randomized trials analyzed as observational studies","volume":"159","author":"Hernan","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib19","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","article-title":"A\u00a0structural approach to selection bias","volume":"15","author":"Hernan","year":"2004","journal-title":"Epidemiology"},{"key":"10.1016\/j.ocarto.2023.100431_bib20","doi-asserted-by":"crossref","DOI":"10.1016\/j.compbiomed.2019.103339","article-title":"ipcwswitch: an R package for inverse probability of censoring weighting with an application to switches in clinical trials","volume":"111","author":"Graffeo","year":"2019","journal-title":"Comput. Biol. Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib21","series-title":"Causal Inference: What If","first-page":"2023","author":"Hernan","year":"2023"},{"key":"10.1016\/j.ocarto.2023.100431_bib22","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1037\/a0031034","article-title":"Mediation analysis allowing for exposure-mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros","volume":"18","author":"Valeri","year":"2013","journal-title":"Psychol. Methods"},{"key":"10.1016\/j.ocarto.2023.100431_bib23","series-title":"Explanation in Causal Inference: Methods for Mediation and Interaction","author":"VanderWeele","year":"2015"},{"key":"10.1016\/j.ocarto.2023.100431_bib24","first-page":"1","article-title":"Mediation: R package for causal mediation analysis","volume":"59","author":"Tingley","year":"2014","journal-title":"J.\u00a0Stat. Software"},{"key":"10.1016\/j.ocarto.2023.100431_bib25","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1037\/a0020761","article-title":"A\u00a0general approach to causal mediation analysis","volume":"15","author":"Imai","year":"2010","journal-title":"Psychol. Methods"},{"key":"10.1016\/j.ocarto.2023.100431_bib26","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/EDE.0000000000000121","article-title":"A\u00a0unification of mediation and interaction: a 4-way decomposition","volume":"25","author":"VanderWeele","year":"2014","journal-title":"Epidemiology"},{"key":"10.1016\/j.ocarto.2023.100431_bib27","series-title":"Advances in Social Science Research Using R","article-title":"Causal mediation analysis using R","author":"Imai","year":"2019"},{"key":"10.1016\/j.ocarto.2023.100431_bib28","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1214\/10-STS321","article-title":"Identification, inference and sensitivity analysis for causal mediation effects","volume":"25","author":"Imai","year":"2010","journal-title":"Stat. Sci."},{"key":"10.1016\/j.ocarto.2023.100431_bib29","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1093\/ije\/dyt127","article-title":"Mediation analysis in epidemiology: methods, interpretation and bias","volume":"42","author":"Richiardi","year":"2013","journal-title":"Int. J. Epidemiol."},{"key":"10.1016\/j.ocarto.2023.100431_bib30","series-title":"R: A Language and Environment for Statistical Computing","isbn-type":"print","year":"2008","ISBN":"https:\/\/id.crossref.org\/isbn\/3900051070"},{"key":"10.1016\/j.ocarto.2023.100431_bib31","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/jama.2021.14075","article-title":"A\u00a0guideline for reporting mediation analyses of randomized trials and observational studies: the AGReMA statement","volume":"326","author":"Lee","year":"2021","journal-title":"JAMA"},{"issue":"3","key":"10.1016\/j.ocarto.2023.100431_bib32","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1002\/acr.24983","article-title":"How do non-surgical interventions improve pain and physical function in people with osteoarthritis? A scoping review of mediation analysis studies","volume":"75","author":"Lima","year":"2023","journal-title":"Arthritis Care Res"},{"key":"10.1016\/j.ocarto.2023.100431_bib33","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/oby.2010.120","article-title":"Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD trial","volume":"19","author":"Foy","year":"2011","journal-title":"Obesity (Silver Spring)"},{"key":"10.1016\/j.ocarto.2023.100431_bib34","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1002\/acr.22775","article-title":"Link between positive clinician-conveyed expectations of treatment effect and pain reduction in knee osteoarthritis, mediated by patient self-efficacy","volume":"68","author":"Hsiao-Wei Lo","year":"2016","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"10.1016\/j.ocarto.2023.100431_bib35","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/tbm\/iby037","article-title":"Effect of intensive diet and exercise on self-efficacy in overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial","volume":"9","author":"Mihalko","year":"2019","journal-title":"Transl Behav Med"},{"key":"10.1016\/j.ocarto.2023.100431_bib36","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/art.1790110205","article-title":"Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain","volume":"11","author":"Rejeski","year":"1998","journal-title":"Arthritis Care Res."},{"key":"10.1016\/j.ocarto.2023.100431_bib37","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/j.joca.2019.04.009","article-title":"Inflammatory cytokines mediate the effects of diet and exercise on pain and function in knee osteoarthritis independent of BMI","volume":"27","author":"Runhaar","year":"2019","journal-title":"Osteoarthritis Cartilage"},{"key":"10.1016\/j.ocarto.2023.100431_bib38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s12529-017-9689-5","article-title":"Cognitive mediators of change in physical functioning in response to a multifaceted intervention for managing osteoarthritis","volume":"25","author":"Taylor","year":"2018","journal-title":"Int. J. Behav. Med."},{"key":"10.1016\/j.ocarto.2023.100431_bib39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jrsm.1087","article-title":"Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions","volume":"5","author":"Stewart","year":"2014","journal-title":"Res. Synth. Methods"}],"container-title":["Osteoarthritis and Cartilage Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2665913123000985?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2665913123000985?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:23:42Z","timestamp":1762939422000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2665913123000985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["S2665913123000985"],"URL":"https:\/\/doi.org\/10.1016\/j.ocarto.2023.100431","relation":{},"ISSN":["2665-9131"],"issn-type":[{"value":"2665-9131","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Mediators of the effects of exercise and manual therapy for people with knee and hip osteoarthritis: A secondary, exploratory analysis of the MOA trial","name":"articletitle","label":"Article Title"},{"value":"Osteoarthritis and Cartilage Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ocarto.2023.100431","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 The Author(s). Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI).","name":"copyright","label":"Copyright"}],"article-number":"100431"}}