Comparing effects of an online exercise plus education program to online education only in people with knee osteoarthritis: randomised controlled trial: The COPE Trial

Participants in both the intervention and controls groups will have access to online educational content for osteoarthritis management in the form of reading material. The online content will be based on current best-practice research and resources that we have previously used for our other studies. Topics covered include: understanding osteoarthritis; osteoarthritis treatment options; exercise and physical activity; weight loss; understanding and managing pain; sleep; links to additional resources. The website can be accessed as many times as the participant wishes. The intervention group will also have access to a self directed online 12-week progressive yoga program guided by an instructor delivering the program in a pre-recorded video format. Videos of the yoga program will run approximately 30-40 minutes each and will look like a class session with an instructor and a small group of people performing as people with knee osteoarthritis. Classes will be beginner to intermediate in level/intensity and will progress throughout the 12 weeks. Participants will be encouraged to monitor their intensity by focusing on the ability to breathe in a slow, controlled manner - a common approach in yoga classes. Each class will have several modifications and progressions demonstrated so that participants may choose options that match their abilities as they progress. The intervention will include such things as "chair pose" (yogic squats), "warrior poses" (yogic lunges), "cat/cow pose" (yogic spine mobilization), and "downward dog pose". Breathing techniques will include things such as working to sync movements to breath cycles, and meditation techniques centred around monitoring of the breath. Participants will be able to undertake the program in their home at a time of their choosing. They will be asked to complete the yoga program 3 times per week (approx. 30-40 minutes per session) for the 12 weeks and encouraged to continue with this during the subsequent follow up period. They will watch a new video each week for a total of 12 videos performed a minimum of 3 times each. Adherence will be monitored via self-reported study log books and study questionnaires, and also via website analytics.