The Feldenkrais Method in the Management of Pain, Function and Balance in People with Osteoarthritis of the Knee

INTERVENTION: Feldenkrais Method: The intervention will be gentle self‐regulated ‘awareness through movement’ Feldenkrais Method sessions, guided by a Feldenkrais practitioner (also a podiatrist or physiotherapist) at the Western Sydney University campus. The intervention includes 4 movement workshops of 3 hr duration, performed once per week. Intervention length is 1.5 hours, with the remainder of the time used for measurements and socialisation after the intervention. The Feldenkrais intervention is delivered face to face by the practitioner, to groups of 2 to 6 participants. Target intensity is low, participants are advised they should be comfortable and able to talk easily at the correct level of intensity. There are regular rest periods between techniques. All Feldenkrais sessions will be conducted in positions of support i.e seated position, or use of a back of a chair, or wall for support, to minimise falls risk. Adherence is monitored by the number of times participants attend sessions. Observation of classes by practitioner also ensures participants are engaging in the activity. This is a cross‐over trial. After the intial 4 week intervention the intervention group has no more active intervention, but is followed up at 4 and 8 weeks post intervention. CONDITION: Knee Osteoarthritis PRIMARY OUTCOME: Sit to stand (number repetitions in 60s) Timed up and go (timed 3 metre walk, from a sitting position and return) SECONDARY OUTCOME: Adverse Events ; These are participant reported, e.g increased knee pain after testing, or falls during Feldenkrais class Functional reach: ; The test represents the difference between baseline arm length arm (90 degrees to the chest) and maximal forward reach with the same arm from a fixed standing position . Incidental and Planned Exercise Questionnaire (IPEQ) Knee Injury and Osteoarthritis Outcome Score (KOOS) SF‐36 Squat test (knee angle at onset of pain and time to do 5 reps), Sway (stand on emed pressure plate 30s). Walking speed (walk 5 metres on gaitrite 2mm thick mat) INCLUSION CRITERIA: • Positive knee OA radiographic image of either both or one femoral tibial knee according to the clinical and radiographic criteria, Kellgren and Lawrence Scale, or clinical diagnoses according to the EULAR guidelines based on presence of three symptoms (pain on use, short‐lived morning stiffness and functional limitation) and three signs of knee osteoarthritis (crepitus, restricted movement, and articular instability) • Age 55 years or over. • Independently walking with no ambulatory aids; • Current/ recent knee pain.