Exercise Program for Knee Osteoarthritis

Overseen By Ernest Vina, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Arizona

Disqualifiers: Non-Hispanic, Life expectancy <12 months, Arthroplasty, Inflammatory arthritis, Prevents exercise, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

44 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new exercise program specifically for Hispanic individuals with knee osteoarthritis (OA). It compares two groups: one receives live video sessions with education, muscle strengthening exercises, and family-supported physical activity, while the other receives only educational sessions. The goal is to determine if the exercise program improves daily physical activity levels. Hispanic individuals who experience frequent knee pain and have internet access might be a good fit for this trial. Participants will complete a survey before and three months after the trial to assess its impact. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance exercise programs for knee OA in Hispanic communities.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this exercise program is safe for Hispanics with knee osteoarthritis?

Research shows that physical activity is safe for people with knee osteoarthritis. One study found that exercise, even over several months, did not harm older adults with knee pain. In fact, it improved their symptoms and prevented other health problems.

Similarly, exercises to strengthen muscles are also safe. Studies have shown that resistance training, such as lifting weights or using resistance bands, reduces pain and improves movement in those with knee osteoarthritis. Even high-intensity strength training is well-tolerated by older adults with knee pain.

Thus, both physical activity and muscle strengthening are not only safe but also beneficial for managing knee osteoarthritis. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring a holistic approach to managing knee osteoarthritis (OA), combining education, physical activity, and muscle strengthening. Unlike standard treatments like medication or surgery, this method emphasizes empowering patients with knowledge about OA and encouraging consistent, personalized physical activity. Additionally, the use of dyads, where participants engage in activities with a partner, adds a social element that could enhance motivation and adherence to the program. This innovative combination aims to provide a more sustainable and engaging way to manage OA symptoms.

What evidence suggests that this exercise program is effective for knee osteoarthritis?

This trial will compare different approaches to managing knee osteoarthritis (OA). Participants in one arm will receive educational sessions about OA, a muscle-strengthening program, and a program promoting regular physical activity. Studies have shown that exercise and physical activity benefit people with knee OA. Aerobic exercises, like walking or swimming, can reduce pain and improve knee function. Research also indicates that muscle-strengthening exercises, such as resistance training, can reduce pain and enhance knee strength and functionality. Overall, both regular physical activity and muscle strengthening can help people with knee OA feel better and move more easily. Meanwhile, participants in the control arm will receive only live video educational sessions about OA. ^{1 2 3 6 7}

Who Is on the Research Team?

Ernest Vina, MD

Principal Investigator

University of Arizona

Are You a Good Fit for This Trial?

This trial is for Hispanic individuals over 50 with chronic knee pain and diagnosed with knee osteoarthritis. Participants must have internet access to attend video sessions and be accompanied by a family member or friend who will also participate.

Inclusion Criteria

I am of Hispanic/Latino ethnicity.

I have a device that can connect to the internet.

I am 50 years old or older.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either an intervention with educational sessions, a muscle strengthening program, and a physical activity program, or a control treatment with only educational sessions about OA

12 weeks

Live video consultations

Follow-up

Participants are monitored for adherence, satisfaction, and perceived helpfulness of the program, as well as changes in physical activity and OA symptoms

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Education
• General Physical Activity
• Muscle Strengthening

Trial Overview The study compares two approaches: one includes educational sessions, muscle strengthening exercises, and activities to encourage regular physical activity via live video; the other offers only educational sessions about osteoarthritis.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 3 Interventions

Treatments include educational sessions about OA, a muscle strengthening program, and a program that will aim to promote regular physical activity involving dyads

Group II: Control Active Control 1 Intervention

Treatment only includes live video educational sessions about OA

Who Is Running the Clinical Trial?

University of Arizona

Lead Sponsor

Trials

545

Recruited

161,000+

University of Melbourne

Collaborator

Trials

193

Recruited

1,287,000+

Temple University

Collaborator

Trials

321

Recruited

89,100+

Published Research Related to This Trial

A systematic review of 26 high-quality studies found that various strengthening exercise programs significantly improve pain relief, physical function, and quality of life for patients with knee osteoarthritis within a six-month period.

Combining strengthening exercises with other therapeutic activities, like coordination and balance training, further enhances these benefits, indicating a comprehensive approach may be more effective for managing knee osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Brosseau, L., Taki, J., Desjardins, B., et al.[2022]

An 8-week online exercise and education program for knee osteoarthritis patients improved their sense of ownership over their treatment, leading to better function, well-being, and hope for the future.

While the online format provided beneficial peer support, participants expressed a need for more interactive engagement and suggested combining online sessions with in-person classes for enhanced support and individualized care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An invigorating journey towards better function and well-being: A qualitative study of knee osteoarthritis patients' experiences with an online exercise and education intervention. Simonÿ, C., Clausen, B., Beck, M., et al.[2023]

A hospital-based patient education program was developed to promote walking among patients with knee osteoarthritis, aiming to improve their functional capacity without increasing pain or medication use.

The program integrates theories from patient compliance, exercise compliance, and behavioral psychology, and has been evaluated for both safety and efficacy, highlighting its potential as a structured approach to managing osteoarthritis through physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies. Allegrante, JP., Kovar, PA., MacKenzie, CR., et al.[2019]

A survey of 161 accredited exercise physiologists in Australia revealed that their exercise prescriptions for knee osteoarthritis largely align with clinical guidelines, with 99% prescribing strength exercises and 90% weight-bearing exercises.

However, the education provided by these physiologists was limited, with only 21% offering pain neuroscience education, indicating a gap in comprehensive patient education about knee osteoarthritis management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and education for knee osteoarthritis-What are accredited exercise physiologists providing? Ram, A., Booth, J., Thom, J., et al.[2021]

Patient education about physical activity and exercise is crucial in managing hip and knee osteoarthritis, as it enhances compliance with exercise and weight loss programs, leading to improved function and reduced pain.

A systematic review of 13 randomized controlled trials confirmed that non-pharmacological treatments, including education, exercise, and weight loss, are effective and can lower healthcare costs through self-management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Gay, C., Chabaud, A., Guilley, E., et al.[2022]

Regular light to moderate exercise is beneficial for individuals with knee osteoarthritis (OA), providing both preventive and therapeutic effects.

Exercise regimens that focus on aerobic conditioning and lower extremity strength training have strong evidence supporting their effectiveness, and healthcare providers should confidently recommend tailored exercise plans to help manage OA symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of exercise and physical activity on knee osteoarthritis. Esser, S., Bailey, A.[2021]

In a study involving 102 elderly subjects with knee osteoarthritis, both high-resistance and low-resistance strength training significantly improved pain, function, walking time, and muscle torque over 8 weeks.

While both types of training were effective, high-resistance training showed a greater improvement compared to low-resistance training, suggesting it may be more beneficial for elderly individuals with mild to moderate knee OA, even though the differences were not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Jan, MH., Lin, JJ., Liau, JJ., et al.[2022]

Exercise is a safe and effective non-drug treatment for osteoarthritis (OA) of the hip and knee, showing small to moderate improvements in pain and function similar to those achieved with NSAIDs.

Both aerobic and strengthening exercises are equally effective for managing pain and improving function in OA patients, and combining diet with exercise may provide additional benefits, especially for obese individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of strengthening, aerobic, and coordination exercises for patients with osteoarthritis. Bischoff, HA., Roos, EM.[2022]

Mind-body exercise programs, such as Hatha Yoga and Tai Chi, have been shown to effectively improve pain relief and physical function in patients with knee osteoarthritis, based on a systematic review of high-quality studies.

Hatha Yoga and Tai Chi Qigong received high grades for their effectiveness, with significant improvements noted in pain relief and quality of life, making them valuable non-traditional exercise options for managing knee osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Brosseau, L., Taki, J., Desjardins, B., et al.[2022]

A program combining patient education and tailored exercise significantly reduced pain and improved function in 142 knee osteoarthritis patients over a 6-month period, as evidenced by improvements in pain scores and physical performance tests.

The use of analgesics decreased from 43.2% at baseline to 18.9% at the 6-month follow-up, indicating that the intervention not only helped with pain relief but also reduced reliance on medication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effect of education and tailored exercise therapy on knee osteoarthritis patients]. Wang, K., Liu, Q., Lin, JH., et al.[2018]

In a randomized controlled trial involving 90 patients with knee osteoarthritis, adding lower limb strength training to neuromuscular exercise and education did not significantly improve self-reported physical function compared to exercise and education alone after 12 weeks.

While the strength training group showed a slight advantage in stair climbing performance, most other outcomes, including pain and quality of life, showed no significant differences between the two groups, indicating that the low-dose strength training approach did not provide additional clinical benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care - a randomized controlled trial. Holm, PM., Schrøder, HM., Wernbom, M., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12273085/

Effectiveness of exercise therapy in patients with knee ... This study aimed to assess the methodological quality of published systematic reviews of exercise therapy in knee osteoarthritis and summarise ...

2. bmj.com bmj.com/content/391/bmj-2025-085242

systematic review and network meta-analysis Conclusions In patients with knee osteoarthritis, aerobic exercise is likely the most beneficial exercise modality for improving pain, function, ...

3. jospt.org jospt.org/doi/10.2519/jospt.2018.7877

Physical Activity and Exercise Therapy Benefit More Than ... Physical activity and exercise therapy not only improve symptoms and impairments of OA, but are also effective in preventing at least 35 chronic conditions.

4. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/2778536

Effects of a Self-directed Web-Based Strengthening ... Main Outcomes and Measures Primary outcomes were change in overall knee pain (numeric rating scale, 0-10) and difficulty with physical function ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2590109523000186

Improving the Effectiveness of Exercise Therapy for Adults ... Exercise is recommended for knee OA but effects are small and reduce over time. · This randomized trial compared 3 physical therapist-led exercise interventions.

6. oarsijournal.com oarsijournal.com/article/S1063-4584%2815%2901159-0/fulltext

Is long-term physical activity safe for older adults with knee ... Long-term therapeutic exercise lasting 3 to 30 months is safe for most older adults with knee pain. This evidence supports current clinical guideline ...

7. reumatismo.org reumatismo.org/reuma/article/view/1466

The preventive and therapeutic role of physical activity in ... Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb ...