Education and exercise

The GLA:D® program is an education and exercise program that has helped thousands of people with hip and knee osteoarthritis (OA) manage their symptoms of pain and loss of function.

The program reflects the latest OA research and has been developed based on feedback from people with OA, as well as healthcare professional who provide care to individuals with mild to severe symptoms. GLA:D® therefore provides an evidence-based approach that works in the real world.

To determine if you will benefit from the GLA:D® program you will undergo an assessment by a health care practitioner, which will include a physical assessment as well as some functional tests. Once you have been told the program is right for you, the GLA:D® program consists of:

• • 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 exercise sessions twice a week for six weeks to improve muscle control and stability of the joint, which leads to reduction in symptoms and improved quality of life. Participants are are educated on how to include the neuromuscular exercises in daily physical activity and advised to continue to be physically active to ensure that the improvements in muscle stabilization are maintained in the long term.
• The majority of patients will be encouraged to attend these classes in a group session as the evidence shows that this results in the best improvements in symptoms. However some individuals who are more active or have less ability to attend can receive the program on an individual basis.

Format of group training session

Each training session lasts 60 minutes and consists of three parts: warm up, circuit training and cool down.

Warm up

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.”

Circuit training

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.

Cool down

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.

Learn more about the GLA:D™ Canada program, including the exercises being performed, in the video below: