Now Recruiting

MOA 2: the DEMO Trial

MOA 2: the DEMO trial – Dosing, Exercise and Manual therapy in Osteoarthritis

Principal Investigators

  • Dr J. Haxby Abbott (Orthopaedic Surgery, Department of Surgical Sciences)
  • Assoc Prof G. Kelley Fitzgerald (University of Pittsburgh)
  • Assoc Prof Julie M. Fritz (University of Utah)
  • Assoc Prof John Childs (US Army-Baylor University)


  • Dr Gerard Brennan (Intermountain Health Care, Utah)
  • Assoc Prof Kenneth Smith (University of Pittsburgh)
  • Assoc Prof Douglas Landsittel (University of Pittsburgh)

Demo Trial Co-Ordinator

  • Cathy Chapple (Orthopaedic Surgery, Department of Surgical Sciences)

Study Details

Exercise therapy is known to be effective, and is recommended as the first line of treatment for patients with knee osteoarthritis (OA), a major cause of pain, disability and healthcare costs. However if not continued, the benefits diminish within months. It is believed that ‘booster’ intervention sessions help make effects endure, improving long-term outcome, but their effectiveness has not been adequately tested. There are also early indications that manual therapy may improve the effectiveness of exercise therapy.

In this international, multi-centre, randomised clinical trial we will investigate the effectiveness – and the cost-effectiveness – of regularly scheduled booster sessions as a strategy for maintaining the beneficial effects of exercise therapy in 300 people with knee OA; and will test the effect of providing manual therapy in addition to exercise therapy as a strategy for increasing the magnitude of effect of exercise therapy, to one- and two-years follow-up.


This research is funded by the United States Agency for Healthcare Research and Quality (AHRQ), the University of Otago, and conducted during tenure of Dr Abbott’s Sir Charles Hercus Health Research Fellowship of the Health Research Council of New Zealand.