# Boosting Exercise Adherence in Knee Osteoarthritis (BOOST-OA)

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2026 · —

## Abstract

Background: Knee osteoarthritis (OA) is a leading cause of functional limitations among Veterans. Physical
therapy (PT), with a focus on exercise, has strong evidence for improving physical function and other
outcomes among individuals with knee OA. However, low adherence to home exercise is a major challenge
both during the episode of care and following completion of therapy, significantly limiting the effectiveness of
PT for knee OA. A recent systematic review highlighted the need for rigorous development and testing of
interventions to enhance adherence to home exercise in the context of physical rehabilitation. In this project,
we will test the effectiveness of a theoretically-informed, scalable intervention to enhance adherence to home
exercise among Veterans receiving PT for knee OA. “Boosting Exercise Adherence in Knee Osteoarthritis”
(BOOST-OA) includes components that address both exercise behavior initiation (conducted in conjunction
with the PT episode of care) and maintenance (conducted after completion of PT care). Specifically, BOOST-
OA includes: 1) Tools and activities woven into PT visits that address outcome expectations, action self-
efficacy, goal-setting and monitoring (3-month behavior initiation phase) and 2) Health coaching calls that
address satisfaction with outcomes, relapse prevention planning and independent monitoring (9-month
behavior maintenance phase). Both phases will be supported by tailored messages through Annie, the VA’s
text messaging service. The intervention will address strengthening and stretching exercises, as well as overall
physical activity, as these are all part of a comprehensive approach to mitigating functional losses.
Methods: We propose a pragmatic cluster-randomized trial, with 8 VA PT clinics randomized to BOOST-OA vs.
usual PT care (UC). Participants will be Veterans with symptomatic knee OA (n=360, 45 per site). At BOOST-
OA sites, physical therapy clinicians will deliver behavior initiation components in conj

## Key facts

- **NIH application ID:** 11241465
- **Project number:** 1I01RD000435-01A1
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Kelli D. Allen
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2026
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2026-01-01T00:00:00 → 2030-12-31T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11241465

## Citation

> US National Institutes of Health, RePORTER application 11241465, Boosting Exercise Adherence in Knee Osteoarthritis (BOOST-OA) (1I01RD000435-01A1). Retrieved via AI Analytics 2026-07-01 from https://api.ai-analytics.org/grant/nih/11241465. Licensed CC0.

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