Home › Trials › NCT06488144
Clinical trial Recruiting at 1 site Phase 3 Interventional Ages 40 to 90

Maintaining knee improvement after physical therapy for Veterans

Official title: A Remotely - Applied Behaviorally- Designed Intervention Incorporating Gamification, Social Incentives, and Health Coaching to Improve Durability of Physical Therapy for Knee Osteoarthritis (ReAKTIV)

Run by VA Office of Research and Development · NCT06488144 · Data updated 2026-11-12

This trial tests whether gamified social incentives and optional health coaching help Veterans with knee osteoarthritis stick with prescribed exercises and stay more active after physical therapy.

Quick facts

PhasePhase 3
Study typeInterventional
Ages40 Years to 90 Years
SexAll
Enrollment254 (estimated)
SponsorVA Office of Research and Development
Federal
Locations5 sites (Birmingham, Alabama and 4 other locations)
StatusRecruiting
StartedDecember 10, 2025
Main results expectedMay 31, 2029
Study endsJanuary 1, 2030
Registry record updatedJanuary 8, 2026
Trial IDNCT06488144 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Ideal candidates are Veterans aged 40–90 with a clinical diagnosis of knee osteoarthritis who are beginning or recently began physical therapy, can walk independently, own a smartphone, and can sync a Fitbit monthly.

Probably not a fit

Patients unlikely to benefit include those with inflammatory arthritis, inability to walk two blocks without help, no smartphone access, or severe comorbid illness that limits exercise participation.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a randomized, factorial Phase 3 trial of 254 Veterans with knee osteoarthritis who have recently started physical therapy. Participants use a smartphone platform and Fitbit to capture activity and patient-reported outcomes remotely and are randomized to receive behaviorally-designed gamification with social incentives, health coaching, both, or control (Fitbit only). The interventions target long-term adherence to prescribed exercises and greater overall physical activity after the typical 6–8 week PT course. Outcomes will compare adherence, activity levels, and symptom/function measures over the follow-up period.

Why it matters

Potential benefit: If successful, the interventions could help people maintain the functional gains from physical therapy, reduce pain and medication reliance, and improve long-term mobility.

How similar studies have gone: Previous studies of incentives, gamification, and health coaching show mixed short-term improvements in physical activity, but sustained long-term benefit in knee osteoarthritis remains limited and incompletely proven.

Who can join: the full rules

Show full inclusion / exclusion criteria 
Inclusion Criteria:

* Clinical diagnosis or chronic knee osteoarthritis.
* Age between 40-90 years
* Initiating physical therapy for KOA (has initial appointment within the next month or had first PT visit within the last 7 days)
* To be randomized: PT feels that they are able to safely and reliably participate in ongoing exercise.
* To be randomized: must have completed at least 4 virtual or in-person appointments with PT
* To be randomized: must sync their Fitbit at least monthly.

Exclusion Criteria:

* Lack of a smart phone allowing interaction with the WTH platform
* Inability to walk 2 blocks without assistance
* Poorly controlled crystalline arthritis or other diagnosis of inflammatory arthritis.
* Treating provider or LSI believes life-expectancy is \<1 year
* Based on LSI or treating provider discretion: exclusions may occur for severe heart failure, unstable angina, end stage renal disease, severe chronic obstructive or other pulmonary disease, or other chronic illness felt to limit participants ability to participate in exercise or resulting in potential safety risk
* Severe pain in a non-knee area limiting daily function
* Non-English speakers or poor reading ability limiting ability to interact with text messages.
* Pregnancy
* Receiving physical therapy outside of the VA.

Where it's running

  • Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
    Philadelphia, Pennsylvania, United States     Recruiting
  • Birmingham VA Medical Center, Birmingham, AL
    Birmingham, Alabama, United States     Not yet recruiting
  • Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE
    Omaha, Nebraska, United States     Not yet recruiting
  • VA Portland Health Care System, Portland, OR
    Portland, Oregon, United States     Not yet recruiting
  • VA Puget Sound Health Care System Seattle Division, Seattle, WA
    Seattle, Washington, United States     Not yet recruiting

Study contacts

  • Principal investigator: Joshua F. Baker, MD MSCE — Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
  • Study coordinator: Joshua F Baker, MD MSCE
  • Email: Joshua.Baker@va.gov
  • Phone: (215) 823-5800

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
View on ClinicalTrials.gov ↗ Find more trials like this →
Browse more
Osteoarthritis, Knee 66VA Office of Research and Development 268
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.