Effectiveness of exercises in non-weight positions combined with mobile health on pain, body mass index and exercise adherence in overweight and obese knee osteoarthritis patients: A randomized controlled trial

Intervention will be the lower limb rehabilitation protocol by using mobile health (mHealth). The researcher will allocate selected overweight and obese Knee OA patients into two groups, namely, Group combined with mHealth (Gcw-mHealth), Group without mHealth (Gwo-mHealth). Gcw-mHealth and Gwo-mHealth will perform lower limb rehabilitation exercises at their houses. All groups will be instructed to follow the instructions of daily care. Instructions of daily care are 1. Always prefers to sit than standing. 2. Always walk with a stick. 3. Avoid stair climbing. 4. Do not jog or run as an exercise plan. 5. Always exercise in non-weight bearing positions. e.g sitting or lying positions. 6. Try to reduce your weight by avoiding taking of sugary foods, drinks and high fat foods. Eat mostly plant-based foods. Add omega-3 fatty acids in your daily diet. Intervention will be delivered by the physiotherapist, who has a ten years experience in the field of therapy and rehabilitation. The physiotherapist will teach the training sessions at the study site and the patients will perform their training sessions at their houses. The participants will perform 45-60 minutes of training sessions 3 times a week for duration of 24 weeks. The training sessions will be performed with an intensity of a load equating to an estimated 50 % of 1RM. The training sessions are strengthening exercises of lower limbs rehabilitation protocol in sitting and lying positions without putting mechanical pressure at the knee. Strengthening exercises will be of muscle groups of hip, knee and ankle joints of lower limbs. The exercise adherence will be checked by the attendance of training sessions completed. Intervention will be delivered by mHealth in the form of periodic manual (by hand not automatic) WhatsApp messages in a WhatsApp group. The researcher will send the two text messages per day for three days a week for a period of 24-weeks to the Gcw-mHealth. The researcher will send the text messages between 7:00 to 9:00 a.m. in the morning and 5:00 to 7:00 p.m. in the evening. The patients will perform the lower limb rehabilitation protocol at their houses. Difference between Gcw-mHealth and Gwo-mHealth is the use of WhatsApp to provide manuals. Periodic manual WhatsApp messages will be send as a reminder only to Gcw-mHealth.