{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:49:23Z","timestamp":1791499763538,"version":"4.3.4"},"reference-count":40,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Aging"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Older adults with chronic joint pain often exhibit decreased mobility. Daily walking measures are being increasingly used in aging research as objective indicators of mobility.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n In this study, we aimed to examine the effects of a 12-week hybrid exercise-based program on daily-life walking characteristics.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 59 community-dwelling older adults (aged \u226565 years) with mild to moderate knee and\/or low back pain were randomized to either a hybrid exercise group or an educational control group. Daily-life walking was monitored using an ankle sensor. Daily observation data were collected within 2 planned 7-day windows. Primary parameters included activity volume and gait characteristics. Statistical analyses were conducted based on a modified intention-to-treat principle using linear mixed-effects models, with a per-protocol set used for sensitivity analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mixed-effects analysis based on the modified intention-to-treat principle (n=52 participants; 696 observations) suggested an effect of the intervention on improving walking quality, particularly step length (\u03b2=2.39 cm;\n P<\/jats:italic>\n =.04; Hedges\n g<\/jats:italic>\n =0.493), with a smaller effect with borderline statistical significance observed on improving walking speed (\u03b2=0.05 m\/s;\n P<\/jats:italic>\n =.06; Hedges\n g<\/jats:italic>\n =0.496). Cadence, daily distance, daily steps, active energy expenditure, and accumulated 3 or more metabolic equivalent of task activities showed no clear difference between the groups. In the per-protocol sensitivity analysis (n=44), the same directional pattern of improvement was observed for step length (\u03b2=1.95 cm;\n P<\/jats:italic>\n =.13; Hedges\n g<\/jats:italic>\n =0.365) and walking speed (\u03b2=0.04 m\/s;\n P<\/jats:italic>\n =.14; Hedges\n g<\/jats:italic>\n =0.368); however, the estimates were imprecise.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A 12-week hybrid exercise program may improve the quality of daily-life walking, with the clearest effect observed on step length. Given the attenuation after multiplicity-aware interpretation and in sensitivity analyses, these findings should be interpreted as suggestive rather than definitive.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/97414","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:51:11Z","timestamp":1791496271000},"page":"e97414-e97414","source":"Crossref","is-referenced-by-count":0,"title":["Association Between a Hybrid Video-Guided Multicomponent Exercise Program With Staff Assistance and Free-Living Gait in Older Adults With Knee and Low Back Pain: Secondary Analysis of a Randomized Controlled Trial"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0187-9275","authenticated-orcid":false,"given":"Shuichi 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