GLA:D® Canada Program for Knee & Hip Osteoarthritis

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Why GLA:D®? Program Benefits

The GLA:D® program is the most rigorously studied exercise program for hip and knee OA in the world. Outcomes reported across thousands of participants include:

• Reduction in osteoarthritis symptoms in over 32% of participants
• Over 83% of patients report the program as beneficial
• More than 50% experience a clinically meaningful improvement in function and quality of life
• Increased levels of physical activity
• Reduced reliance on pain medications
• Potential to delay or avoid joint replacement surgery
• Improved surgical outcomes for those who do proceed with joint replacement

Who Is This Program For?

The GLA:D® Canada program is appropriate for adults experiencing hip and/or knee symptoms across a wide spectrum, from early-stage discomfort to moderate or severe osteoarthritis. You may be a good candidate if you:

• Have been diagnosed with hip or knee osteoarthritis (mild, moderate, or severe)
• Experience stiffness, pain, or reduced mobility in your hip or knee joints
• Are currently on a waitlist for joint replacement surgery
• Have reduced your activity levels due to joint pain
• Are seeking a non-surgical, evidence-based approach to managing your symptoms

A thorough initial assessment by one of our GLA:D®-certified practitioners will confirm whether the program is appropriate for your condition and goals.

What to Expect: Program Structure

Step 1: Initial Assessment

Prior to beginning the program, you will undergo a comprehensive one-on-one assessment with a certified clinician. This includes a physical examination, functional movement testing, and a review of your symptoms, activity level, and health history. This assessment ensures the program is safe and appropriate for you, and establishes a baseline for tracking your progress.

Step 2: Education Workshops (2 Sessions)

The two education workshops are a foundational component of the GLA:D® program — and a key reason it produces results that last well beyond the six weeks of exercise. Many patients arrive with misconceptions about osteoarthritis that actually worsen their condition: beliefs such as “pain means damage,” “I should rest to protect my joints,” or “surgery is my only option.” The education workshops are designed to address these directly.

Each workshop runs approximately 60 minutes and is facilitated by your certified physiotherapist. Topics covered include:

• What osteoarthritis actually is: the biological and mechanical processes involved in OA, and why it is a manageable condition — not simply the result of wear and tear
• Pain science: understanding the relationship between pain, movement, and joint health — and why avoiding activity often makes symptoms worse over time
• The role of neuromuscular exercise: how the specific exercises used in this program train the muscles and nervous system to better absorb joint load and reduce stress on the hip or knee
• Self-management strategies: practical tools for managing flare-ups, modifying daily activities, pacing your movement, and maintaining the gains made during the program
• Lifestyle factors: the evidence behind weight management, sleep, stress, and physical activity as they relate to OA symptom progression

The workshops are interactive and delivered in a small group setting. Participants are encouraged to ask questions and share experiences, which many find reduces the sense of isolation that often accompanies a chronic joint condition. Your physiotherapist facilitates discussion and tailors examples to the types of activities and goals most relevant to your group.

Critically, the education component is what enables patients to sustain their improvements after graduating. Understanding why the exercises work — and how to apply the principles of joint load management to daily life — gives patients the confidence and knowledge to self-manage long-term.

Step 3: Neuromuscular Exercise Sessions (12 Sessions over 6 Weeks)

You will attend physiotherapist-supervised exercise sessions twice per week for six weeks. Each session is approximately 60 minutes and is structured around three phases:

• Warm-Up: Joint-specific mobility and activation exercises that prepare the neuromuscular system for training and reduce the risk of symptom aggravation
• Circuit Training: A series of progressive neuromuscular exercises targeting the muscles that support and stabilize the hip and knee joints. Exercises are designed to improve motor control, proprioception, and functional strength — each one adapted to your current ability and progressed over the six weeks as your capacity improves
• Cool-Down: Gentle stretching and mobility work to support recovery and reinforce healthy movement patterns

Exercise sessions are delivered in a small group format. Research consistently shows that group-based delivery of the GLA:D® program produces stronger outcomes than individual sessions, in part because of the peer support, accountability, and shared motivation that participants experience. Individual delivery is available where clinically indicated or where scheduling does not permit group attendance.

Step 4: Outcome Tracking

Standardized functional outcome measures are collected at your initial assessment, at mid-program, and at program completion. These include tests of strength, balance, and mobility as well as validated patient-reported measures of pain and quality of life. Your results are shared with you throughout the program so you can see your progress in concrete terms. Anonymized data also contributes to the national GLA:D® Canada registry, which informs ongoing research and continuous program improvement across the country.

Education Facilitation

Your physiotherapist does not simply deliver educational content — they contextualize it for your specific situation. If you are on a surgical waitlist, they will frame the material around prehabilitation and what to expect. If you are managing work-related activity demands, they will help you apply the self-management principles to your day-to-day environment. This individualized interpretation of the curriculum is something that only a trained clinician can provide.

Motivational Support & Long-Term Self-Management

Adherence is one of the strongest predictors of outcome in exercise-based rehabilitation. Your physiotherapist plays an active role in keeping you engaged throughout the six weeks, addressing concerns as they arise, celebrating measurable progress, and helping you build the habits and confidence needed to remain active after graduating from the program. Many patients find that the therapeutic relationship they develop with their physiotherapist during GLA:D® becomes a foundation for their ongoing self-management well beyond the formal program.

Coordination within Our Multidisciplinary Team

At Delta Physiotherapy & Rehab, your physiotherapist works as part of a collaborative, multidisciplinary healthcare team. If your assessment or progress indicates that additional support may be beneficial, individual physiotherapy or chiropractic care is also available within the clinic when required or recommended. Your physiotherapist may also recommend further consultation with your physician when appropriate.This integrated approach ensures that the GLA® program is not delivered in isolation, but as part of a comprehensive treatment and management plan tailored to your individual needs, goals, and overall health.

Frequently Asked Questions