Objective This study aimed to establish the validity of the KOJI AWARENESSTM sub-components by determining whether there is a connection between the sub-component scores and joint range of motion, muscle strength, and balance.

Methods Fifty healthy adults (17 females and 33 males) participated in the study, completing both the KOJI AWARENESSTM and measurements of joint range of motion, muscle strength, and balance. The range of motion of the upper and lower extremities and trunk was measured using either a goniometer or an inclinometer. A handheld dynamometer was used to measure muscle strength. Balance ability was assessed using a modified balance error scoring system. Using the Mann–Whitney U test or Jonckheere–Terpstra test, we compared the KOJI AWARENESS™ score and the corresponding body segments, with a significance level of P ≤ 0.05.

Results Our results indicated that there were associations between external references and many items, but no associations were found for flexion, extension, and rotation of the "neck mobility," extension and external rotation of the "hip mobility," and strength of the "mid-section stability strength" in the KOJI AWARENESSTM.

Conclusion Overall, the KOJI AWARENESSTM sub-component scores showed good validity, with the exception of the items related to neck and hip flexibility and trunk muscle strength. Future analyses should include a wider range of age groups, such as middle-aged and elderly individuals.

The authors have declared no competing interest.

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This study was approved by the Research Ethics Committee of Tokyo Medical and Dental University (research protocol identification number: M2021-029) and followed the Declaration of Helsinki Ethical Principles (52nd WMA General Assembly, Edinburgh, Scotland; October 2000) for medical research involving human subjects.

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