Effect of a Village Doctor-delivered Exercise Therapy for Knee Osteoarthritis

The goal of this clinical trial is to test the feasibility of village doctor-delivered exercise therapy for knee osteoarthritis in rural China, and to preliminarily explore its treatment effects. The main questions it aims to answer are: 1. Is the exercise therapy delivered by village doctors feasible with satisfactory participant adherence? 2. Can this intervention produce preliminary benefits in this small pilot sample? Researchers will compare village doctor-delivered exercise therapy to usual care to see if the intervention leads to greater pain relief and functional improvement in this pilot study. Participants will complete village-delivered exercise therapy three times a week for 12 weeks, then maintain independent exercise for another 12 weeks or receive usual care for a total of 24 weeks.

Inclusion Criteria: 1. aged 50-80 years; 2. clinically diagnosed KOA according to the National Institute for Health and Care Excellence clinical criteria for OA (aged ≥45 years, activity-related knee pain, and either no morning joint-related stiffness or morning stiffness lasting no longer than 30 minutes); 3. knee pain occurring on most days for over three months; 4. the VAS pain score (range 0-10) ≥4; 5. Kellgren-Lawrence (KL) grade of 2-3; 6. residency in the designated village for the study duration. Exclusion Criteria: 1. have received intra-articular knee injections for pain within the past six months; 2. have a history of knee surgery or have a planned knee replacement; 3. have rheumatoid arthritis or other inflammatory joint diseases; 4. possess physical or mental comorbidity that could interfere with the exercise regimen; 5. have engaged in regular or organized exercise therapy within the past six months; 6. are involved in an ongoing clinical trial