The education and exercise program reflects the latest evidence in osteoarthritis (OA) research. It also includes feedback from people with OA and trainers on what works in the real world to manage OA symptoms.
The training consists of:
- A first appointment explaining the program and collecting data on the participants’ current functional ability.
- Two education sessions which teach participants about OA, including the degeneration process in the joint, how the GLA:D™ Canada exercises improve joint stability, and how to retain this improved joint stability through day to day self-management techniques.
- Neuromuscular training sessions twice a week for six weeks to improve muscle control of the joint which leads to reduction in symptoms and improved quality of life.Patients are encouraged to attend these classes in a group session. For those who do not wish to participate in group training, some sites are able to provide the option of attending three individual sessions with the GLA:D™ Canada trainer and undertaking the neuromuscular exercises for six weeks twice a week at home. The cost will be the same for the two types of programs. As part of the program, participants are educated on how to include the neuromuscular exercises in daily physical activity and advised to continue to train and be physically active to ensure that the improvements in muscle stabilization are maintained in the long term.
Format of group training session
Each training session lasts 60 minutes and consists of three parts: warm up, circuit training and cool down.
This portion consists of a 10-minute warm-up on an exercise bike. The workload is adjusted individually and can be increased throughout with the goal of it feeling “somewhat hard.”
The circuit-training consists of four stations:
- Core stability (abdominal area)
- Postural orientation (keeping the weight well placed over the leg)
- Muscle strength in the legs
- Functional training exercises
Two exercises are performed in each station. These exercises are chosen by the trainers based on the findings from the initial assessment. Each exercise is performed in 2-3 sets of 10-15 repetitions. Each patient is monitored individually, so that the exercise is being completed correctly to address the individual’s neuromuscular function. There are many levels of difficulty for each exercise and the individual is progressed through these levels as they are able by varying the number, direction and speed of movements. The difficulty is increased only when the individual is able to perform the exercise with good neuromuscular control and quality. Exercises are performed with both legs, although the focus is on the affected leg. Some of the exercises are performed in front of a mirror to provide visual feedback of the movement.
The cool down consists of walking exercises forwards and backwards, about 10 m in each direction, in front of a mirror, and stretching exercises for the legs (front and back of the thigh), either in standing with support or in lying. Stretching is carried out for about 10 minutes.