A Telehealth Physical Therapy Intervention to Increase Physical Activity in Adults With Knee OA: The Delaware PEAK Randomized Controlled Trial.

Single site, single treating PT, so results reflect one clinician's delivery style and one practice setting. Neither participants nor the PT were blinded to group assignment. 15 of 103 randomized participants were excluded from the primary analysis for lacking valid baseline monitor data, leaving 88 in the modified ITT sample. Only 67 participants had valid monitor data at 12 weeks, below the 84 the study was powered for. The sample was 82.5% female, 84.5% White, and 80% college-educated, with few males (17.5%), Black (7.8%), or Hispanic (2.9%) participants. Online recruitment via Facebook may have missed older adults and those with lower household income. Fixed block size of 4 makes the randomization sequence more predictable than variable block sizes. The intervention included step goals, strength training, and education together, so the contribution of any single component to the (null) activity outcome cannot be separated. The authors note a mismatch between the step-count goal and the MVPA primary outcome, since each step counted equally regardless of intensity.

Funded by the NIH (extramural) and a non-U.S. government source, as listed in the publication types. No specific industry sponsor or author conflict of interest is stated in the provided text.

Do not read the per-protocol finding of 849 more steps per day at 24 weeks as proof the programme increases physical activity. The primary outcome was null, the per-protocol sample (n = 71) is a post-hoc subset of the full randomized group, and the exploratory pain and function gains were not the study's primary question.