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Physical Therapy Versus Internet-Based Exercise Training for Patients With Knee Osteoarthritis (PATH-IN)

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ClinicalTrials.gov Identifier: NCT02312713
Recruitment Status : Completed
First Posted : December 9, 2014
Results First Posted : October 27, 2017
Last Update Posted : October 27, 2017
Sponsor:
Collaborator:
Patient-Centered Outcomes Research Institute
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Single (Outcomes Assessor);   Primary Purpose: Treatment
Condition Knee Osteoarthritis
Interventions Behavioral: Internet Based Exercise Training
Behavioral: Physical Therapy
Enrollment 350
Recruitment Details  
Pre-assignment Details  
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Period Title: Overall Study
Started 140 142 68
Completed 129 112 63
Not Completed 11 30 5
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control Total
Hide Arm/Group Description

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention Total of all reporting groups
Overall Number of Baseline Participants 140 142 68 350
Hide Baseline Analysis Population Description
[Not Specified]
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 140 participants 142 participants 68 participants 350 participants
65.7  (10.3) 65.3  (11.5) 64.3  (12.2) 65.3  (11.1)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
Female
40
  28.6%
44
  31.0%
15
  22.1%
99
  28.3%
Male
100
  71.4%
98
  69.0%
53
  77.9%
251
  71.7%
Ethnicity (NIH/OMB)  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
Hispanic or Latino
4
   2.9%
4
   2.8%
1
   1.5%
9
   2.6%
Not Hispanic or Latino
134
  95.7%
138
  97.2%
67
  98.5%
339
  96.9%
Unknown or Not Reported
2
   1.4%
0
   0.0%
0
   0.0%
2
   0.6%
Race (NIH/OMB)  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
American Indian or Alaska Native
1
   0.7%
1
   0.7%
1
   1.5%
3
   0.9%
Asian
1
   0.7%
8
   5.6%
2
   2.9%
11
   3.1%
Native Hawaiian or Other Pacific Islander
0
   0.0%
1
   0.7%
1
   1.5%
2
   0.6%
Black or African American
24
  17.1%
33
  23.2%
13
  19.1%
70
  20.0%
White
109
  77.9%
94
  66.2%
49
  72.1%
252
  72.0%
More than one race
1
   0.7%
2
   1.4%
1
   1.5%
4
   1.1%
Unknown or Not Reported
4
   2.9%
3
   2.1%
1
   1.5%
8
   2.3%
Body Mass Index  
Mean (Standard Deviation)
Unit of measure:  Kg/m2
Number Analyzed 140 participants 142 participants 68 participants 350 participants
31.9  (8.6) 31.5  (7.8) 30.1  (7.3) 31.4  (8.0)
Married or Living with Partner  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
80
  57.1%
93
  65.5%
42
  61.8%
215
  61.4%
Bachelors Degree or More Education  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
86
  61.4%
80
  56.3%
42
  61.8%
208
  59.4%
Employed  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
59
  42.1%
51
  35.9%
31
  45.6%
141
  40.3%
Low Income Financial Status   [1] 
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
20
  14.3%
29
  20.4%
13
  19.1%
62
  17.7%
[1]
Measure Description: "Low income" defined as self report of “just meeting basic expenses” or “don’t even have enough to meet basic expenses" vs. responses of "live comfortably or "meet your basic expenses with a little left over for extras" in response to a question asking participants to "describe your household’s financial situation."
Fair or Poor Self-Reported Health   [1] 
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 140 participants 142 participants 68 participants 350 participants
14
  10.0%
22
  15.5%
12
  17.6%
48
  13.7%
[1]
Measure Description:

Participants were asked, "How would you rate your current health?" Options were: excellent, very good, good, fair and poor.

For this metric we grouped those reporting fair or poor.

Number of Joints with Arthritis Symptoms  
Mean (Standard Deviation)
Unit of measure:  Joints
Number Analyzed 140 participants 142 participants 68 participants 350 participants
5.5  (3.0) 5.2  (3.1) 5.5  (3.9) 5.4  (3.2)
Self-reported Years with Arthritis Symptoms  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 140 participants 142 participants 68 participants 350 participants
14.1  (11.6) 11.6  (11.0) 14.2  (13.0) 13.1  (11.7)
1.Primary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index Score
Hide Description Change over time in the primary outcome measure for this study, the WOMAC is a measure of lower extremity pain (5 items), stiffness (2 items), and function (17 items). The scale ranges from 0-96 with higher scores indicating worse symptoms and function.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
-6.73
(-8.86 to -4.60)
-6.06
(-8.29 to -3.84)
-3.37
(-6.33 to -0.41)
Baseline to 12 Month Change
-4.42
(-6.66 to -2.17)
-5.46
(-7.82 to -3.09)
-2.83
(-5.93 to 0.27)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -3.36
Confidence Interval (2-Sided) 95%
-6.84 to 0.12
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.39
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.59
Confidence Interval (2-Sided) 95%
-5.26 to 2.08
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.14
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.70
Confidence Interval (2-Sided) 95%
-6.24 to 0.85
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.17
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.63
Confidence Interval (2-Sided) 95%
-6.37 to 1.11
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments The IBET intervention will be non-inferior to the standard PT intervention, indicated by a mean WOMAC score less than 5 points higher than standard PT.
Statistical Test of Hypothesis P-Value 0.65
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.67
Confidence Interval (2-Sided) 95%
-2.23 to 3.56
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments The IBET intervention will be non-inferior to the standard PT intervention, indicated by a mean WOMAC score less than 5 points higher than standard PT.
Statistical Test of Hypothesis P-Value 0.51
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.04
Confidence Interval (2-Sided) 95%
-4.13 to 2.05
Estimation Comments [Not Specified]
2.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in the Satisfaction With Physical Function Scale
Hide Description This is a validated, 5-item questionnaire that assesses patients’ satisfaction with their ability to complete basic functional tasks that are often affected by lower extremity OA, including stair-climbing, walking, doing housework (light and heavy, and lifting and carrying). All 5 items are rated on a 7 point scale ranging from Very Dissatisfied (-3) Very Satisfied (+3). The total scale ranges from -15 to +15,with higher scores indicating greater satisfaction with function.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
0.84
(0.6 to 1.09)
0.35
(0.09 to 0.61)
0.28
(-0.07 to 0.63)
Baseline to 12 Month Change
0.39
(0.14 to 0.64)
0.43
(0.16 to 0.70)
0.16
(-0.19 to 0.51)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.01
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Median Difference (Final Values)
Estimated Value 0.56
Confidence Interval (2-Sided) 95%
0.15 to 0.98
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.28
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.23
Confidence Interval (2-Sided) 95%
-0.19 to 0.65
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.75
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.07
Confidence Interval (2-Sided) 95%
-0.35 to 0.49
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.22
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.27
Confidence Interval (2-Sided) 95%
-0.16 to 0.7
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.5
Confidence Interval (2-Sided) 95%
-0.84 to -0.16
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.83
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.04
Confidence Interval (2-Sided) 95%
-0.31 to 0.39
Estimation Comments [Not Specified]
3.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Objective Physical Function - 2 Minute Step Test
Hide Description One of 4 tests that objectively assessed physical function. These 4 tests included: unilateral stand time; time to rise from a chair and return to the seated position for 30 seconds; timed up and go- rise from a seated position, walk a short distance and return to seated position; and a 2 minute step test. For this outcome measure, the 2 minute step test, the minimum is 0 steps and there is no maximum scale score (participants complete as many steps as they can in 2 minutes); greater steps indicate better function.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: number of steps taken in 2 minutes
Baseline to 4 Month Change
-0.68
(-5.07 to 3.71)
-3.54
(-8.20 to 1.11)
-8.43
(-14.61 to -2.24)
Baseline to 12 Month Change
1.11
(-3.45 to 5.67)
1.12
(-3.76 to 6)
0.00
(-6.49 to 6.48)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for the 2 Minute Step Test.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.04
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 7.75
Confidence Interval (2-Sided) 95%
0.43 to 15.07
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for the 2 Minute Step Test.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.78
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.12
Confidence Interval (2-Sided) 95%
-6.59 to 8.82
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for the 2 Minute Step Test.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.20
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 4.88
Confidence Interval (2-Sided) 95%
-2.56 to 12.33
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for the 2 Minute Step Test.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value .78
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.13
Confidence Interval (2-Sided) 95%
-6.74 to 8.99
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for the 2 Minute Step Test.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.35
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.86
Confidence Interval (2-Sided) 95%
-8.94 to 3.21
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for the 2 Minute Step Test.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 1.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.01
Confidence Interval (2-Sided) 95%
-6.40 to 6.42
Estimation Comments [Not Specified]
4.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Objective Physical Function- Unilateral Stand Time
Hide Description One of 4 tests that objectively assessed physical function. These 4 tests included: unilateral stand time; time to rise from a chair and return to the seated position for 30 seconds; timed up and go- rise from a seated position, walk a short distance and return to seated position; and a 2 minute step test. For this outcome measure, the unilateral stand test, scores scan range from 0-10 seconds, with higher time indicating better balance.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: seconds
Baseline to 4 Month Change
-0.59
(-1.15 to -0.03)
0.02
(-0.57 to 0.61)
0.04
(-0.75 to 0.82)
Baseline to 12 Month Change
-0.05
(-0.6 to 0.50)
-0.05
(-0.64 to 0.53)
-0.09
(-0.88 to 0.69)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for Unilateral Stand Time.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.19
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.63
Confidence Interval (2-Sided) 95%
-1.56 to 0.30
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for Unilateral Stand Time.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.93
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.04
Confidence Interval (2-Sided) 95%
-0.89 to 0.98
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for Unilateral Stand Time.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.97
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.02
Confidence Interval (2-Sided) 95%
-0.97 to 0.93
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for Unilateral Stand Time
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.93
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.04
Confidence Interval (2-Sided) 95%
-0.91 to 1
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for Unilateral Stand Time.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.12
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.61
Confidence Interval (2-Sided) 95%
-0.16 to 1.38
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for Unilateral Stand Time.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 1.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.00
Confidence Interval (2-Sided) 95%
-0.78 to 0.77
Estimation Comments [Not Specified]
5.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Objective Physical Function - 30 Second Chair Stand
Hide Description One of 4 tests that objectively assessed physical function. These 4 tests included: unilateral stand time; time to rise from a chair and return to the seated position for 30 seconds; timed up and go- rise from a seated position, walk a short distance and return to seated position; and a 2 minute step test. For this outcome measure, the 30 second chair stand test, the minimum is 0 stands and there is no maximum scale score (participants complete as many stands as they can in 30 seconds; greater numbers of stands indicate better function.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: number of stands from a chair in 30 sec
Baseline to 4 Month Change
-0.13
(-0.87 to 0.61)
0.50
(-0.29 to 1.28)
0.18
(-0.87 to 1.23)
Baseline to 12 Month Change
0.16
(-0.49 to 0.82)
0.90
(0.20 to 1.60)
0.66
(-0.27 to 1.58)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for 30 Second Chair Stand.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.63
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.31
Confidence Interval (2-Sided) 95%
-1.55 to .94
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for 30 Second Chair Stand.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.37
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.49
Confidence Interval (2-Sided) 95%
-1.58 to 0.6
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for 30 Second Chair Stand.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.62
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.32
Confidence Interval (2-Sided) 95%
-0.95 to 1.59
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for 30 Second Chair Stand.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.67
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.24
Confidence Interval (2-Sided) 95%
-0.87 to 1.35
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for 30 Second Chair Stand.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.23
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.63
Confidence Interval (2-Sided) 95%
-0.40 to 1.66
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for 30 Second Chair Stand.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.11
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.74
Confidence Interval (2-Sided) 95%
-0.17 to 1.64
Estimation Comments [Not Specified]
6.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Objective Physical Function- Timed Up and Go
Hide Description One of 4 tests that objectively assessed physical function. These 4 tests included: unilateral stand time; time to rise from a chair and return to the seated position for 30 seconds; timed up and go- rise from a seated position, walk a short distance and return to seated position; and a 2 minute step test. For this outcome measure, the timed up and go, there are no minimum or maximum scores (participants complete the task as quickly as they are able); shorter (lower) times indicate better function.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: seconds
Baseline to 4 Month Change
-0.62
(-1.34 to 0.09)
-0.87
(-1.63 to -0.11)
-0.23
(-1.24 to 0.78)
Baseline to 12 Month Change
-0.77
(-1.57 to 0.04)
-1.49
(-2.35 to -0.63)
-0.26
(-1.4 to 0.87)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for Timed Up and Go.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.52
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.39
Confidence Interval (2-Sided) 95%
-1.58 to 0.8
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for Timed Up and Go.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.46
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.5
Confidence Interval (2-Sided) 95%
-1.86 to 0.85
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for Timed Up and Go.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.3
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.64
Confidence Interval (2-Sided) 95%
-1.85 to 0.58
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for Timed Up and Go.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.08
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.22
Confidence Interval (2-Sided) 95%
-2.61 to 0.16
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for Timed Up and Go.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.63
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.24
Confidence Interval (2-Sided) 95%
-1.23 to 0.74
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for Timed Up and Go.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.21
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.72
Confidence Interval (2-Sided) 95%
-1.85 to 0.41
Estimation Comments [Not Specified]
7.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in the Patient Health Questionnaire-8
Hide Description Depressive symptoms and severity will be assessed using the PHQ-8, a reliable and valid measure of depression71. The PHQ-8 is an eight-item survey derived from the Primary Care Evaluation of Mental Disorders (PRIME-MD) diagnostic tool, and consists of items corresponding to the depression criteria listed in the Diagnostic and Statistics Manual Fourth Edition (DSM-IV). Each of the eight questions is scored as 0 (not at all) to 3 (nearly every day), so that total scores range from 0 to 24, with higher scores indicating more depressive symptoms.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
-0.46
(-0.94 to 0.02)
-0.22
(-0.73 to 0.29)
0.33
(-0.36 to 1.01)
Baseline to 12 Month Change
0.1
(-0.45 to 0.65)
0.1
(-0.49 to 0.69)
0.99
(0.22 to 1.77)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.05
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.79
Confidence Interval (2-Sided) 95%
-1.59 to 0.02
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.05
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.9
Confidence Interval (2-Sided) 95%
-1.82 to 0.02
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.19
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.55
Confidence Interval (2-Sided) 95%
-1.37 to 0.27
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.89
Confidence Interval (2-Sided) 95%
-1.83 to 0.05
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.49
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.23
Confidence Interval (2-Sided) 95%
-0.43 to 0.89
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.99
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0
Confidence Interval (2-Sided) 95%
-0.77 to 0.78
Estimation Comments [Not Specified]
8.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to Month 12 in The Knee Injury and Osteoarthritis Outcome Score (KOOS)
Hide Description The KOOS is a patient-reported outcome measurement instrument, developed to assess the patient’s opinion about their knee and associated problems. Five KOOS subscale scores were administered: Pain (9 items), Function in daily living (17 items), Function in Sport and Recreation (5 items), and knee-related Quality of Life (4 items). All items are scored on 5-point Likert scales. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change - KOOS Pain
6.2
(3.75 to 8.65)
7.77
(5.17 to 10.38)
3.84
(0.38 to 7.29)
Baseline to 12 Month Change - KOOS Pain
3.67
(1.05 to 6.29)
6.18
(3.38 to 8.98)
2.82
(-0.86 to 6.5)
Baseline to 4 Month Change - KOOS ADL
6.8
(4.53 to 9.06)
5.47
(3.08 to 7.87)
3.37
(0.16 to 6.57)
Baseline to 12 Month Change - KOOS ADL
4.65
(2.3 to 7.01)
4.99
(2.48 to 7.49)
2.2
(-1.1 to 5.5)
Baseline to 4 Month Change - KOOS Sport/Rec
5.6
(2.44 to 8.77)
5.4
(2.03 to 8.77)
1.69
(-2.82 to 6.2)
Baseline to 12 Month Change - KOOS Sport/Rec
5.44
(2.07 to 8.8)
5.98
(2.33 to 9.64)
-0.03
(-4.76 to 4.7)
Baseline to 4 Month Change - KOOS QOL
5.56
(2.93 to 8.19)
5.9
(3.11 to 8.69)
2.27
(-1.45 to 5.99)
Baseline to 12 Month Change - KOOS QOL
4.21
(1.64 to 6.78)
6.8
(4.06 to 9.54)
-0.93
(-4.53 to 2.66)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for KOOS Pain.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.36
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.57
Confidence Interval (2-Sided) 95%
-1.77 to 4.92
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months for KOOS Pain.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.17
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.51
Confidence Interval (2-Sided) 95%
-1.11 to 6.14
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for KOOS Pain.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.94
Confidence Interval (2-Sided) 95%
-0.19 to 8.06
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for KOOS Pain.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.14
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.36
Confidence Interval (2-Sided) 95%
-1.08 to 7.79
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Standard Physical Therapy and Wait List Control at 4 months for KOOS Pain.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.25
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.37
Confidence Interval (2-Sided) 95%
-1.67 to 6.4
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Standard Physical Therapy and Wait List Control at 12 months for KOOS Pain.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.70
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.85
Confidence Interval (2-Sided) 95%
-3.48 to 5.18
Estimation Comments [Not Specified]
Show Statistical Analysis 7 Hide Statistical Analysis 7
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for KOOS ADL.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.40
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.32
Confidence Interval (2-Sided) 95%
-4.43 to 1.79
Estimation Comments [Not Specified]
Show Statistical Analysis 8 Hide Statistical Analysis 8
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for KOOS ADL.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.84
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.33
Confidence Interval (2-Sided) 95%
-2.93 to 3.59
Estimation Comments [Not Specified]
Show Statistical Analysis 9 Hide Statistical Analysis 9
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 month for KOOS ADL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.28
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.11
Confidence Interval (2-Sided) 95%
-1.73 to 5.94
Estimation Comments [Not Specified]
Show Statistical Analysis 10 Hide Statistical Analysis 10
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 month for KOOS ADL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.17
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.79
Confidence Interval (2-Sided) 95%
-1.2 to 6.77
Estimation Comments [Not Specified]
Show Statistical Analysis 11 Hide Statistical Analysis 11
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for KOOS ADL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.07
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.43
Confidence Interval (2-Sided) 95%
-0.32 to 7.18
Estimation Comments [Not Specified]
Show Statistical Analysis 12 Hide Statistical Analysis 12
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for KOOS ADL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.22
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.45
Confidence Interval (2-Sided) 95%
-1.44 to 6.34
Estimation Comments [Not Specified]
Show Statistical Analysis 13 Hide Statistical Analysis 13
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for KOOS Sport/Rec.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value .92
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.21
Confidence Interval (2-Sided) 95%
-4.47 to 4.06
Estimation Comments [Not Specified]
Show Statistical Analysis 14 Hide Statistical Analysis 14
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for KOOS Sport/Rec.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value .82
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value .55
Confidence Interval (2-Sided) 95%
-4.15 to 5.24
Estimation Comments [Not Specified]
Show Statistical Analysis 15 Hide Statistical Analysis 15
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for KOOS Sport/Rec.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.17
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.71
Confidence Interval (2-Sided) 95%
-1.59 to 9
Estimation Comments [Not Specified]
Show Statistical Analysis 16 Hide Statistical Analysis 16
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for KOOS Sport/Rec.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.04
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 6.01
Confidence Interval (2-Sided) 95%
0.29 to 11.74
Estimation Comments [Not Specified]
Show Statistical Analysis 17 Hide Statistical Analysis 17
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for KOOS Sport/Rec.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.14
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.91
Confidence Interval (2-Sided) 95%
-1.28 to 9.1
Estimation Comments [Not Specified]
Show Statistical Analysis 18 Hide Statistical Analysis 18
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for KOOS Sport/Rec.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.05
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 5.47
Confidence Interval (2-Sided) 95%
-0.1 to 11.03
Estimation Comments [Not Specified]
Show Statistical Analysis 19 Hide Statistical Analysis 19
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for KOOS QOL.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value .86
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value .33
Confidence Interval (2-Sided) 95%
-3.29 to 3.96
Estimation Comments [Not Specified]
Show Statistical Analysis 20 Hide Statistical Analysis 20
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for KOOS QOL.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.15
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.59
Confidence Interval (2-Sided) 95%
-0.96 to 6.13
Estimation Comments [Not Specified]
Show Statistical Analysis 21 Hide Statistical Analysis 21
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for KOOS QOL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.11
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.63
Confidence Interval (2-Sided) 95%
-0.85 to 8.11
Estimation Comments [Not Specified]
Show Statistical Analysis 22 Hide Statistical Analysis 22
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for KOOS QOL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 7.74
Confidence Interval (2-Sided) 95%
3.39 to 12.08
Estimation Comments [Not Specified]
Show Statistical Analysis 23 Hide Statistical Analysis 23
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for KOOS QOL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.14
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 3.29
Confidence Interval (2-Sided) 95%
-1.08 to 7.67
Estimation Comments [Not Specified]
Show Statistical Analysis 24 Hide Statistical Analysis 24
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for KOOS QOL.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.02
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 5.15
Confidence Interval (2-Sided) 95%
0.92 to 9.37
Estimation Comments [Not Specified]
9.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in The PROMIS Sleep-related Impairment Instrument
Hide Description The PROMIS adult sleep related impairment item bank focuses on self-reported perceptions of alertness, sleepiness, and tiredness during usual waking hours, and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness. It assesses sleep-related impairment over the past seven days. This scale includes 8 items, each measured on a 5-point Likert scale. Per PROMIS scoring instructions, raw scores are converted into standardized t-scores with a mean of 50 and standard deviation of 10. T-scores can range from 30.5-77.6; higher scores indicate worse sleep impairment.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
-3.13
(-4.37 to -1.89)
-0.94
(-2.26 to 0.38)
-0.54
(-2.32 to 1.23)
Baseline to 12 Month Change
-2.16
(-3.47 to -0.86)
-0.45
(-1.84 to 0.94)
-1.1
(-2.93 to 0.72)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.02
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.58
Confidence Interval (2-Sided) 95%
-4.67 to -0.5
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.33
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.06
Confidence Interval (2-Sided) 95%
-3.22 to 1.09
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.72
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.39
Confidence Interval (2-Sided) 95%
-2.52 to 1.74
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.56
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.65
Confidence Interval (2-Sided) 95%
-1.56 to 2.86
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.01
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.19
Confidence Interval (2-Sided) 95%
0.48 to 3.9
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.71
Confidence Interval (2-Sided) 95%
-0.1 to 3.52
Estimation Comments [Not Specified]
10.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in The PROMIS Fatigue Instrument
Hide Description The PROMIS Fatigue instruments evaluate a range of self-reported symptoms, from mild subjective feelings of tiredness to an overwhelming, debilitating, and sustained sense of exhaustion that likely decreases one’s ability to execute daily activities and function normally in family or social roles. Fatigue is divided into the experience of fatigue (frequency, duration, and intensity) and the impact of fatigue on physical, mental, and social activities. It assesses fatigue over the past seven days, This scale includes 8 items, each measured on a 5-point Likert scale. Per PROMIS scoring instructions, raw scores are converted into standardized t-scores with a mean of 50 and standard deviation of 10. T-scores can range from 33.1-77.8; higher scores indicate worse fatigue.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
-0.91
(-2.21 to 0.38)
0.57
(-0.81 to 1.94)
1.55
(0.31 to 3.42)
Baseline to 12 Month Change
0.09
(-1.05 to 1.24)
0.88
(-0.35 to 2.1)
2.52
(0.93 to 4.12)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.03
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.47
Confidence Interval (2-Sided) 95%
-4.67 to -0.26
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.01
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -2.43
Confidence Interval (2-Sided) 95%
-4.31 to -0.55
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.39
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.99
Confidence Interval (2-Sided) 95%
-3.24 to 1.27
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.1
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -1.65
Confidence Interval (2-Sided) 95%
-3.58 to 0.29
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.11
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.48
Confidence Interval (2-Sided) 95%
-0.33 to 3.29
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.33
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.79
Confidence Interval (2-Sided) 95%
-0.8 to 2.37
Estimation Comments [Not Specified]
11.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in the The Brief Fear of Movement Scale
Hide Description The Brief Fear of Movement Scale is a six item scale for assessing fear of movement in OA. The scale specifically assesses activity avoidance due to pain-related fear of movement. All items are measured on a 4-point scale from “strongly agree” to “strongly disagree.” The score ranges from 0-24 with higher scores indicating more fear of movement.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
-0.34
(-0.84 to 0.15)
0.01
(-0.52 to 0.53)
0.45
(-0.26 to 1.15)
Baseline to 12 Month Change
0.28
(-0.19 to 0.74)
0.06
(-0.44 to 0.56)
0.28
(-0.37 to 0.93)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.79
Confidence Interval (2-Sided) 95%
-1.62 to 0.04
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 1.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Net)
Estimated Value 0
Confidence Interval (2-Sided) 95%
-0.77 to 0.77
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.31
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.44
Confidence Interval (2-Sided) 95%
-1.29 to 0.41
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.58
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.22
Confidence Interval (2-Sided) 95%
-1.01 to 0.57
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.32
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.35
Confidence Interval (2-Sided) 95%
-0.33 to 1.03
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.51
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.22
Confidence Interval (2-Sided) 95%
-0.86 to 0.43
Estimation Comments [Not Specified]
12.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in the Physical Activity Scale for the Elderly (PASE)
Hide Description

The Physical Activity Scale for the Elderly (PASE) is a self-report, 12-item scale that measures level occupational, household, and leisure activity during a one-week period. This scale was particularly developed for use among older adults; although all participants in the proposed study will not be age 65 or over, patients with knee OA typically have more limited physical activity than the general population. Therefore we believe this scale will be more applicable to our participant group than scales that were developed for younger adults.

The typical range for the total PASE score is 0-400, with higher scores indicating greater activity.

Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: units on a scale
Baseline to 4 Month Change
2.25
(-9.18 to 13.68)
-11.52
(-23.79 to 0.74)
-4.7
(-21.04 to 11.64)
Baseline to 12 Month Change
8.28
(-2.01 to 18.56)
8.19
(-2.99 to 19.37)
1.17
(-13.11 to 15.45)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.48
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 6.95
Confidence Interval (2-Sided) 95%
-12.31 to 26.22
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.41
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 7.11
Confidence Interval (2-Sided) 95%
-9.69 to 23.91
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.50
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -6.82
Confidence Interval (2-Sided) 95%
-26.55 to 12.91
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.43
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 7.02
Confidence Interval (2-Sided) 95%
-10.31 to 24.35
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.09
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -13.77
Confidence Interval (2-Sided) 95%
-29.73 to 2.19
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet-Based Exercise Training at 12 months.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.99
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.09
Confidence Interval (2-Sided) 95%
-14.41 to 14.23
Estimation Comments [Not Specified]
13.Secondary Outcome
Title Change From Baseline to Month 4 and Change From Baseline to 12 Month in Additional Self-Report Physical Activity Items
Hide Description Number of minutes per week, on average, they are completing strengthening, stretching, and aerobic exercises. The minimum score is 0, and there is no maximum score; higher scores indicate more weekly activity.
Time Frame baseline, 4 months, and 12 months
Show Outcome Measure DataHide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Standard Physical Therapy Internet Based Exercise Training Wait List Control
Hide Arm/Group Description:

Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be “semi-standardized,” meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

Physical Therapy: Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals' functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Participants assigned to the internet-based exercise training arm will be given access to a program that aims to tailor exercises based on individuals’ functional levels. The program assigns specific exercises, progresses these exercises as appropriate over time, and shows individual video clips to demonstrate appropriate performance of exercises.

Internet Based Exercise Training: Participants assigned to the PT arm will receive 3-8 individual visits with a physical therapist. The content of these visits will be "semi-standardized," meaning that they will include some common core components (e.g., evaluation, prescription of home exercise program), but the therapists will have flexibility in terms of how many visits are appropriate and the details of the visit content.

no intervention
Overall Number of Participants Analyzed 140 142 68
Least Squares Mean (95% Confidence Interval)
Unit of Measure: minutes per week
Baseline to 4 Month Change - Strengthening Exercis
1.78
(0.99 to 2.57)
1.27
(0.44 to 2.11)
0.43
(-0.69 to 1.54)
Baseline to 12 Month Change - Strengthening Exerc
1.07
(0.23 to 1.91)
1.21
(0.32 to 2.1)
-0.14
(-1.32 to 1.04)
Baseline to 4 Month Change - Stretching
1.45
(0.76 to 2.15)
0.97
(0.23 to 1.72)
-0.4
(-1.39 to 0.6)
Baseline to 12 Month Change - Stretching
0.27
(-0.37 to 0.92)
0.72
(0.04 to 1.41)
-1.34
(-2.24 to -0.44)
Baseline to 4 Month Change - Aerobic Exercises
1
(-0.02 to 2.02)
1.79
(0.71 to 2.88)
-0.09
(-1.53 to 1.35)
Baseline to 12 Month Change - Aerobic Exercises
0.48
(-0.67 to 1.63)
0.41
(-0.82 to 1.63)
-1.59
(-3.21 to 0.04)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for Strengthening Exercises
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.04
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.36
Confidence Interval (2-Sided) 95%
0.05 to 2.66
Estimation Comments [Not Specified]
Show Statistical Analysis 2 Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for Strengthening Exercises.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.09
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.21
Confidence Interval (2-Sided) 95%
-0.18 to 2.6
Estimation Comments [Not Specified]
Show Statistical Analysis 3 Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for Strengthening Exercises.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.22
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.85
Confidence Interval (2-Sided) 95%
-0.49 to 2.19
Estimation Comments [Not Specified]
Show Statistical Analysis 4 Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for Strengthening Exercises.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.06
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.35
Confidence Interval (2-Sided) 95%
-0.08 to 2.78
Estimation Comments [Not Specified]
Show Statistical Analysis 5 Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for Strength.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.36
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.51
Confidence Interval (2-Sided) 95%
-1.6 to 0.58
Estimation Comments [Not Specified]
Show Statistical Analysis 6 Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for Strength.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.81
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.14
Confidence Interval (2-Sided) 95%
-1.03 to 1.31
Estimation Comments [Not Specified]
Show Statistical Analysis 7 Hide Statistical Analysis 7
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for Stretching.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.85
Confidence Interval (2-Sided) 95%
0.67 to 3.03
Estimation Comments [Not Specified]
Show Statistical Analysis 8 Hide Statistical Analysis 8
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for Stretching.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.62
Confidence Interval (2-Sided) 95%
0.55 to 2.68
Estimation Comments [Not Specified]
Show Statistical Analysis 9 Hide Statistical Analysis 9
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for Stretching.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.03
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.37
Confidence Interval (2-Sided) 95%
0.16 to 2.57
Estimation Comments [Not Specified]
Show Statistical Analysis 10 Hide Statistical Analysis 10
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for Stretching.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.00
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.07
Confidence Interval (2-Sided) 95%
0.98 to 3.16
Estimation Comments [Not Specified]
Show Statistical Analysis 11 Hide Statistical Analysis 11
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for Stretching.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.33
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.48
Confidence Interval (2-Sided) 95%
-1.46 to 0.5
Estimation Comments [Not Specified]
Show Statistical Analysis 12 Hide Statistical Analysis 12
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 12 months for Stretching.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.32
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.45
Confidence Interval (2-Sided) 95%
-0.44 to 1.34
Estimation Comments [Not Specified]
Show Statistical Analysis 13 Hide Statistical Analysis 13
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 4 months for Aerobic Exercise.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.21
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.09
Confidence Interval (2-Sided) 95%
-0.61 to 2.8
Estimation Comments [Not Specified]
Show Statistical Analysis 14 Hide Statistical Analysis 14
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Wait List Control
Comments This is the comparison between Physical Therapy and Wait List Control at 12 months for Aerobic Exercise.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.04
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 2.07
Confidence Interval (2-Sided) 95%
0.13 to 4
Estimation Comments [Not Specified]
Show Statistical Analysis 15 Hide Statistical Analysis 15
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 4 months for Aerobic Exercise.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.03
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.89
Confidence Interval (2-Sided) 95%
0.15 to 3.62
Estimation Comments [Not Specified]
Show Statistical Analysis 16 Hide Statistical Analysis 16
Statistical Analysis Overview Comparison Group Selection Internet Based Exercise Training, Wait List Control
Comments This is the comparison between Internet Based Exercise Training and Wait List Control at 12 months for Aerobic Exercise.
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.05
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 1.99
Confidence Interval (2-Sided) 95%
0.01 to 3.97
Estimation Comments [Not Specified]
Show Statistical Analysis 17 Hide Statistical Analysis 17
Statistical Analysis Overview Comparison Group Selection Standard Physical Therapy, Internet Based Exercise Training
Comments This is the comparison between Physical Therapy and Internet Based Exercise Training at 4 months for Aerobic Exercise.
Type of Statistical Test Non-Inferiority
Comments Since there were not sufficient data in prior literature to specific an a priori non-inferiority margin, for this and other secondary outcomes we based conclusions and discussions on magnitude of differences between the group, descriptively. This strategy was specified in the protocol.
Statistical Test of Hypothesis P-Value 0.27
Comments [Not Specified]
Method Mixed Models Analysis
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value 0.79
Confidence Interval (2-Sided) 95%
-0.62 to 2.2
Estimation Comments [Not Specified]