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What is the PEAK program?

This article talks about the PEAK training program created by Rana Hinman and Kim Bennell, and their program and training modules.

The PEAK Program: Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis.

What is the PEAK program?

The PEAK program is an evidence-based management program for people with knee osteoarthritis. It was devised by researchers at the University of Melbourne for delivery by physiotherapists in Australia but is relevant to physiotherapists globally.

The program is based around education, strengthening exercise and physical activity interventions, delivered during five consultations over three months, and can be individualised to patient needs.

You may download or print off the resources contained within the training modules and reproduce these for patient use. Please note, English language PDF booklets will only be available to learners who choose the course upgrade option.

However, we have some foreign language translations of these resources available for free at the Centre for Health, Exercise and Sports Medicine website

The PEAK program and training modules

The PEAK program and training modules were developed specifically for use in an NHMRC-funded clinical trial comparing video conferencing to face-to-face care by physiotherapists for people with knee osteoarthritis (still ongoing) and in particular, for patients who fulfil the following inclusion/exclusion criteria.

Application of the PEAK program to patients outside of these inclusion/exclusion criteria must be undertaken with caution and in consideration of whether the PEAK program is appropriate and safe for any given individual, using your clinical judgement and any restrictions to clinical practice that may apply in your jurisdiction.

Inclusion criteria:

i) meet National Institute for Health and Care Excellence clinical criteria for OA:

  • age ≥45 years;
  • activity-related knee joint pain;
  • morning knee stiffness ≤ 30 mins;

ii) report a history of knee pain ≥ 3mths;
iii) report knee pain on most days of the past month;
iv) report an average pain score of at least 4 on an 11-point numeric rating scale during walking over the previous week;
v) report difficulty walking and climbing stairs;
vi) have access to a device with an internet connection; and
viii) pass the Exercise and Sports Science Australia stage 1 pre-exercise screening questions.

Exclusion criteria:

i) inability to speak English;
ii) on the waiting list for/planning knee/hip surgery in the next 12 months;
iii) the previous arthroplasty on the affected knee;
iv) recent knee surgery (past 6 months);
v) consulting/ed physiotherapy or doing strengthening exercise for knee (past 6 mths);
vi) self-reported inflammatory arthritis (eg rheumatoid arthritis);
vii) any neurological condition affecting lower limbs; and/or
viii) any unstable/uncontrolled cardiovascular condition.

Clearance to participate from a general practitioner will be required for anyone who i) reported a fall (past 12 months) or is housebound due to immobility, or ii) who fails the Exercise and Sports Science Australia stage 1 pre-exercise screening questions.

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Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis (PEAK)

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