Exercise first: what nearly 10,000 Australians with osteoarthritis tell us
For knee osteoarthritis, exercise and education are recommended as first line care. The challenge has always been delivering them consistently, at scale, outside a research trial. A large new Australian cohort study shows it can be done.
The program
GLA:D Australia combines two group education sessions with 12 supervised exercise classes over six weeks, delivered by trained physiotherapists. Researchers analysed outcomes for 9,938 participants with complete three month data (Alamneh et al., Osteoarthritis and Cartilage Open, 2026).
The results for knee osteoarthritis
At three months, people with knee osteoarthritis reported:
Less pain: worst pain fell by 16.7 points on a 100 point scale.
Better function: KOOS 12 function scores rose by 10.6 points.
Small gains in quality of life.
Location made little difference
Perhaps the most encouraging finding: there were no significant differences between people in metropolitan areas and those in rural and remote locations, or by education level. Private clinics saw slightly larger pain improvements than public ones, but the authors judged the gap small and unlikely to be clinically meaningful.
What this means in practice
Offer exercise and education before referral for surgery. It is effective and it works across settings.
Structure beats generic advice. A defined program with clear dosage and supervision is what delivered these results.
Think about what happens after week six. The study reports three month outcomes. Keeping patients exercising beyond the program is where long term benefit is won or lost.
That last point is where home programs and digital support can help, keeping the structure of a supervised program going once the classes finish.
This article is general information for health professionals and is not clinical advice.
