Randomized Trial Comparing AI-Tailored Home Physiotherapy Versus Clinic-Based Rehab in Knee Osteoarthritis

Background: Knee osteoarthritis (OA) is a prevalent degenerative joint condition and a leading cause of pain and disability worldwide. While physiotherapy is a cornerstone of non-surgical OA management, barriers to accessing clinic-based care often reduce adherence and limit outcomes. Technological innovations such as artificial intelligence (AI) offer a novel solution for delivering personalized, home-based rehabilitation. Objective: To compare the effectiveness of AI-tailored home physiotherapy with traditional clinic-based rehabilitation in improving function, reducing pain, and enhancing satisfaction among patients with knee OA. Methods: A 12-month, single-blind randomized controlled trial was conducted in Lahore, Pakistan, with 144 participants aged 45–70 years diagnosed with grade II–III knee OA. Participants were randomly assigned to either an AI-driven home physiotherapy group or a standard clinic-based rehabilitation group (n = 72 per group). Outcomes were measured at baseline, 6 weeks, and 12 weeks using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS) for pain, Timed Up and Go (TUG) test, and patient satisfaction ratings. Statistical analyses included repeated-measures ANOVA and independent t-tests with significance set at p < 0.05. Results: Participants in the AI group showed significantly greater improvements in WOMAC scores (58.6 ± 6.9 to 29.5 ± 6.2) and VAS scores (7.2 ± 1.0 to 3.1 ± 1.1) compared to the clinic group (p < 0.01). TUG test times and patient satisfaction ratings also favored the AI intervention. No adverse events were reported. Conclusion: AI-tailored home physiotherapy is a clinically effective and patient-preferred alternative to conventional rehabilitation for knee OA, offering scalable benefits for enhancing access and outcomes in musculoskeletal care.