A personalised cycling exercise program for Osteoarthritis patients after surgery

Intervention: A purpose-built cycling device with an inbuilt power meter. Non-drug trial: The exercise device is a purpose build stationary cycle with power meters in the pedal cranks (Infocrank, Australia). The device will be adjusted by a member of the research team to fit the participant who will then be seated to commence familiarisation and establish the initial exercise prescription. This initial exercise is not part of the test, it is to establish the participant's baseline in order for the exercise program to be prescribed. The resistance and cadence of cycling will be adjusted until the participant can cycle at a comfortable rate. This will be maintained for 20 minutes, with further adjustment as needed based on patient feedback. During the test, a reported level of perceived exertion of between 3 or 4 on the 0 to 10 Borg scale will be the goal. The power output will be monitored during the familiarisation session, and the average power achieved during the trial will be used as the baseline exercise prescription. There is no goal for the amount of power output at baseline. The test will be terminated if the participant reports undue fatigue, or increased pain at any stage. Participants will take the cycle device home along with instructions related to the frequency and duration of their cycling program. The cycling program will commence once the participant is comfortable to do so. They will also have instructions about how to change the resistance of the cycle so the exercise dose can be adjusted. The cycle will have an electronic tablet attached to the handlebars which will provide visual feedback about the power output during the cycling session. This information is collected through a purpose-developed application so that each exercise session can be remotely monitored for compliance by the orthopaedic surgeon and research team. Participants will report their pain and level of perceived exertion at the end of each exercise session. The heartrate during each session will also be monitored using a smartwatch wrist band. The cycling program will continue for 4 weeks, with 5 exercise sessions of 20 minutes duration per week. At the end of each week, the exercise compliance and patient feedback will be reviewed and the power output increased if the baseline level is achieved, and level of perceived exertion falls below the required level. To progress the exercise dose, the resistance will be increased to achieve and increase in average power output of 20W. The participant will be notified of these changes via email or text.