Effects of a Machine Learning-based Lower Limb Exercise Training System for Knee Pain

The goal of the study is to confirm the idea of AI-powered Technological Surrogate Physiotherapist (TSP), by demonstrating its effectiveness and value as a new technology-based contribution to OA healthcare. Participants will be randomized to one of two groups: (1) the conventional PT group receiving the exercise program delivered through in-person sessions; or (2) the AI-guided group following the program through the TSP after an initial PT session. All individuals will take part in the study for 12 weeks, and data will be collected at baseline and 12 weeks after randomization.

Inclusion criteria: 1. At least 50 years of age; 2. Report having knee pain most days of the week; 3. Has radiographic evidence of grade 2, 3, or 4 knee OA on the K-L scale in the posteroanterior and/or skyline view in at least 1 knee; 4. Willing and able, both physically and cognitively, to perform the exercises required in the study protocol; 5. Has normal or corrected-to-normal vision; 6. Able to speak Cantonese and read Chinese, AND 7. Able to provide written informed consent. Exclusion criteria: 1. Having a history of knee or hip replacement surgery; 2. Being nonambulatory; 3. Having systemic inflammatory arthritis (e.g., gout); 4. Having a history of trauma (e.g., fractures around the knee, dislocation, sprains or tears of soft tissues like ligaments) or surgical arthroscopy of either knee within the past 6 months; 5. Having intra-articular injection to the knee within the past 6 months; 6. Having cognitive impairment; 7. Involvement in a similar study (i.e., involving physical exercise or physical therapies for knee pain) within the past 6 months; 8. Undergoing recent or imminent surgery (within 3 months) , OR 9. Having medical co-morbidities that preclude participation in exercise.