The ACT-ON: A Geriatric 5-Ms-Guided Physical Therapy Intervention for Knee Osteo-Arthritis in Older Adults.
- Sponsor
- King Saud University
- Study ID
- NCT07640529
- Status
- Not Yet Recruiting
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Conditions
- Excercise
- Geriatric
- Knee Osteoarthristis
- Knee Osteoarthritis
- Physical Therapy
- Rehabilitation
- Rehabilitation Exercise
- Rehabilitation Outcome
Eligibility Criteria
- Sex
- ALL
- Age
- 55 Years - 90 Years
- Healthy Volunteers
- Accepted
Interventions
- Geriatric 5Ms framework — OTHERMind will be addressed through brief cognitive screening at baseline and by monitoring performance during simple dual-task activities to support safety. Therapeutic interventions must be tailored to the patient's cognitive capacity, with environmental structuring and guided strategies provided for those with impaired cognition to ensure safe task completion. Mobility will be the primary focus of each session and will include individualized gait training, balance exercises, strengthening, and fall-prevention strategies appropriate for knee osteoarthritis. The exercise program must be explicitly progressive and systematically address strength, range of motion (ROM), and functional mobility. This requires regular screening and examination of gait, balance, transfer ability, and endurance to quantify improvement and guide interventions. A combined model integrating high-intensity resistance training with neuromuscular exercises is recommended to synergistically target muscle capacity.
- Exercises PT — OTHERThis standard protocol will consist of the following core components: strengthening exercises for key lower limb muscle groups (quadriceps, hamstrings, and hip abductors); aerobic conditioning such as walking or stationary cycling; and training focused on flexibility, balance, range of motion, and gait. Additionally, participants will receive standardized biomedical education covering topics essential for osteoarthritis self-management, including weight management, joint protection principles, anatomy and biomechanics of the knee, and tissue healing timelines.
Study Details
The study is a Random control trail study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, focusing on Application of 5 framework in rehabilitation program of knee arthritis. The study will involve a in each group sample of 20 KOA patients, with a 12-month duration. The sample size was estimated using G\*Power 3.1 software, and the initial power analysis indicated that 40 participants would be required to achieve 80.0% statistical power. The study's participants will be aged between 55 and 80 years, diagnosed with Knee osteoarthritis, without cognitive impairment, knee surgery in the past 6 months, or unstable comorbidities. The study will involve in-person 16 sessions, with the first two lasting approximately one hour and the remaining session 30-45 minutes. The main outcome measures that will be used in this study are Stay Independent Brochure, Iconographical Falls Efficacy Scale (icon-FES), Timed Up and Go, 2-Minute Walk Test, 5 Time Set to Stand Test AND Arthritis Self-Efficacy Scale 8 Item (ASES-8), Patient-Specific Functional Scale (PSFS), and Patient satisfaction level with Physical Therapy service MedRisk. Data will be taken from direct questions to patients, by filling out the questionnaire via Google Form, and through some tests and SPSS will be used for data analysis, with ANOVA Test intervention scores of the outcome measures.
Key Dates
- First listed
- Jun 10, 2026
- Start date
- May 15, 2026
- Status verified
- Jun 2026
- Primary completion
- Sep 15, 2026
- Completion
- Oct 15, 2026
Study Design
- Enrollment
- 40 participants (estimated)
- Allocation
- RANDOMIZED
- Intervention model
- PARALLEL
- Primary purpose
- TREATMENT
Arms
- Experimental: 5Ms-guided physical therapyParticipants in the experimental group will receive all components of the standard physical therapy program. In addition, treatment will be systematically guided by the Geriatric 5Ms framework (What Matters Most, Medications, Mind, Mobility, and Multi-complexity). What Matters Most: Shared goal setting using the Patient-Specific Functional Scale to align exercises with patient-prioritized activities. Mobility: Emphasis on individualized gait, balance, strengthening, functional training, and fall-prevention strategies, with progressive exercise prescription. Mind: Baseline cognitive screening and ongoing monitoring during therapy activities to ensure safety and appropriate task demands. Medications: Weekly monitoring of self-reported medication use and side effects solely to inform exercise safety, with referral to physicians when concerns arise. Multi-complexity: Adaptation of exercise prescription based on comorbidities, fatigue, pain, and functional tolerance, with ongoing clinicalM
- Active Comparator: Standard impairment-based physical therapyParticipants will receive a structured impairment-based physical therapy program aligned with current clinical practice guidelines for knee osteoarthritis. Core components will include lower-limb strengthening (quadriceps, hamstrings, hip abductors), aerobic conditioning (e.g., walking or stationary cycling), flexibility, balance, range of motion, gait training, and standardized biomedical education addressing osteoarthritis self-management (weight management, joint protection, knee anatomy and biomechanics, and tissue healing timelines). Exercise intensity and progression will follow established principles of progressive overload and American College of Sports Medicine (ACSM) guidelines, progressing from low to moderate intensity based on participant tolerance and safety.
Primary Outcome Measure
Knee Outcome Survey Activities of daily living scale (KOS-ADLS) [ Time Frame: Showed high responsiveness to clinical change, with a large effect size (1.12) and a minimum clinically important difference (MCID) of 14 points and the minimal detectable change (MDC) is 7.43 points over a 4-week period ]
Central Contacts
- Bashayer Soliman Alrasheedi, DPT0559566449
- Maha Mohammad Almarwani, Assistant professor,0118058400
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