Experiences and perceptions of a 12-week combined exercise and dietary supplement program for individuals with knee osteoarthritis: a qualitative focus group study.

Six main themes emerged from participants' experiences with a combined exercise and dietary supplementation program for knee osteoarthritis.

• Themes identified were: (1) recognized effects of exercise, (2) motivators and barriers to exercise, (3) group exercise and its impact on daily life, (4) recognized health care limitations, (5) experiences and practices of dietary supplement use, and (6) perspectives on program continuation and expansion.
• Data were analysed using inductive thematic analysis.
• The sample included 16 older adults with KOA (Kellgren-Lawrence grade 1–3), comprising 14 women and 2 men.
• Three focus groups were conducted immediately after the 12-week program.

Participants reported reduced pain, improved mood, and enhanced social engagement as benefits of the combined program.

• Reported benefits included reduced pain, improved mood, and enhanced social engagement.
• These benefits emerged from qualitative focus group discussions among 16 older adults with KOA.
• Participants attributed these benefits to the combined exercise and dietary supplementation program.

Participants experienced multiple barriers to participation in the program.

• Barriers included physical limitations, time constraints, and psychological challenges.
• These barriers were identified across three focus groups involving 16 participants.
• Barriers were identified through inductive thematic analysis of focus group data.

Social support, professional guidance, and self-motivation were identified as important facilitators of program participation.

• Participants highlighted the importance of social support, professional guidance, and self-motivation.
• Group exercise was identified as a distinct theme ('group exercise and its impact on daily life'), suggesting the social dimension of exercise was salient to participants.
• Two moderators facilitated each focus group using a topic guide to explore motivational factors.

Participants tended to perceive exercise and dietary supplementation as separate rather than integrated components of the combined intervention.

• Participants' tendency to perceive exercise and supplementation as separate components indicates that combined interventions may function as parallel rather than integrated strategies.
• This separation occurred unless the intervention was explicitly framed and supported as a unified approach.
• Experiences and practices of dietary supplement use emerged as a distinct theme, separate from exercise-related themes, reflecting this perceived separation.
• The combination of structured exercise with dietary supplements was noted as underexplored, especially through qualitative approaches.

Participants expressed perspectives on continuation and expansion of the program following its completion.

• 'Perspectives on program continuation and expansion' was identified as one of the six main themes.
• Focus groups were conducted immediately after the 12-week program to capture these perspectives.
• The study was registered on ClinicalTrials.gov as NCT06269549, registered on 13th February 2024.

Healthcare system limitations were recognized by participants as a relevant theme in managing knee osteoarthritis.

• 'Recognized health care limitations' was identified as one of the six main themes from inductive thematic analysis.
• This theme emerged from focus group discussions among 16 older adults with Kellgren-Lawrence grade 1–3 KOA.
• The theme suggests participants perceived gaps or constraints in available healthcare support for KOA management.