Exercise and Cognitive Behavioural Therapy for Knee Osteoarthritis

To investigate the benefits of a 12-week intervention involving 10 weekly treatment sessions delivered by a physiotherapist on a one-to-one basis. This is a 12 week intervention because prior to meeting the physiotherapist at week 1 and week 12 the participant will attend the university for laboratory assesssment and we will request that the participant wear a pedometer for 7 days straight and record the number of steps they have taken on a data collection sheet during both periods. They will see the physiotherapist from weeks 2-11. The study will examine the effectiveness of a combined exercise and Cognitive Behavioural Therapy (CBT) intervention compared to each intervention (CBT or Exercise) alone. All interventions will be delivered by a sole health care professional - specially trained physiotherapists. This means that the exercise and CBT components can be integrated and delivered in the same session. Intervention Groups: i) Exercise Alone - 25 minute treatment sessions X 10 sessions This component is comprised of: -quadraceps strengthening -sitting knee extension -hip abductor strengthening -partial wall squats -sit to stand exercise -hamstring strengthening -step up and step down exercise ii) CBT Alone - 45 minute treatment sessions X 10 sessions This component is comprised of: -explanation of the gate control theory -progressive muscle relaxation -relaxation training and and explanation of its benefits -identifying and challenging negative thoughts -problem solving -pleasant imagery and counting backwards iii) CBT plus Exercise - 70 minute treatment sessions X 10 sessions This component is comprised of a combination of i) & ii) above.