What the GLA:D ® Program Teaches us About Telehealth Physiotherapy
Telehealth & osteoarthritis
Does online physiotherapy actually work? What the GLA:D® Australia trial tells us about telehealth and hip and knee osteoarthritis
James Combes — Director & Head Physiotherapist, Telephysio Australia
Telehealth evidence - Osteoarthritis - Rural access
When people first hear about telehealth physiotherapy, the scepticism is understandable. Can an online consultation really replace hands-on care? Can a physiotherapist accurately assess your movement through a screen? Will exercise prescribed via video call actually be safe and effective?
These are fair questions, and for people living with hip or knee osteoarthritis, they matter enormously. Osteoarthritis is one of the most common and debilitating musculoskeletal conditions in Australia, affecting over 2.1 million Australians. For many, particularly those in rural and regional areas where specialist allied health services are scarce, access to quality physiotherapy care has historically been out of reach.
Fortunately, the research is now giving us clear answers. And one of the most compelling pieces of evidence comes from the GLA:D® Australia program.
What is GLA:D®?
GLA:D® - Good Life with osteoArthritis from Denmark - is a structured, evidence-based program designed specifically for people with hip or knee osteoarthritis. Originally developed in Denmark and now delivered across Australia, GLA:D® combines two education sessions with supervised neuromuscular exercise therapy, delivered twice weekly over six weeks by trained physiotherapists.
The goal of GLA:D® is not simply pain relief. It is to help people understand their condition, improve neuromuscular control, build the strength and movement patterns that protect the joint, reduce reliance on pain medication, and critically - delay or avoid surgery altogether.
Research from Denmark, where the program was developed, shows that symptom progression reduces by 32% in GLA:D® participants, with less pain, reduced use of joint-related pain relief, and less time off work reported across multiple studies.
In Australia, GLA:D® has been implemented across both private and public settings - and more recently, a significant portion of its delivery has shifted to telehealth formats, with physiotherapists delivering both education sessions and exercise sessions via video call. That shift created a natural opportunity to ask a rigorous question: does GLA:D® delivered online produce the same results as in-person?
What the research found
A program evaluation led by Ezzat and colleagues — published in the Journal of Telemedicine and Telecare — examined GLA:D® Australia data from patients who completed the program via telehealth-only or a hybrid telehealth-and-in-person model. The findings are worth examining closely.
Key research
Implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia: a mixed-methods program evaluation
Ezzat AM, Kemp JL, Heerey JJ, Pazzinatto MF, De Oliveira Silva D, Dundules K, Francis M, Barton CJ. Journal of Telemedicine and Telecare. 2025;31(1):104–120.
Evaluated GLA:D® delivered via telehealth-only and hybrid models across Australian clinics. Measured patient satisfaction, functional outcomes, pain, quality of life, and physiotherapist experience with the telehealth format.
The headline findings are striking. For patients who completed GLA:D® via telehealth-only, 99% reported being satisfied or very satisfied with their experience. For those in the hybrid model, that figure was 85%. Nearly two out of three patients reached a minimally clinically important improvement in quality of life - the threshold at which a change is meaningful in day-to-day life, not just measurable on a chart.
99% Satisfied or very satisfied — telehealth-only delivery
85% Satisfied or very satisfied — hybrid delivery
2 in 3 Patients reached a clinically meaningful quality of life improvement
Source: Ezzat et al., Journal of Telemedicine and Telecare, 2025;31(1):104–120.
Beyond satisfaction, the clinical outcomes were consistent with what the broader GLA:D® Australia program has demonstrated in in-person delivery moderate to large improvements in pain, function, and quality of life. The chair stand test, a key marker of lower limb strength and functional capacity, showed group-level improvements exceeding the minimally clinically important change threshold. Patients reported reduced pain, improved mobility, and for many a reduced perceived need for surgery.
"GLA:D® delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters."
Ezzat AM et al. Journal of Telemedicine and Telecare. 2025;31(1):104–120.
Why telehealth works for osteoarthritis management
For people with hip or knee osteoarthritis, the traditional barrier to effective physiotherapy has rarely been willingness it has been access. Getting to a clinic twice a week for six weeks is a significant logistical commitment, particularly for older Australians, those with limited mobility, or anyone living more than a short drive from an allied health service.
Telehealth removes that barrier without compromising the quality of the program. Here is why the online format is particularly well-suited to osteoarthritis management:
Education translates seamlessly online: The GLA:D® education component understanding osteoarthritis, its progression, and the role of exercise is delivered as structured sessions that work just as effectively via video call as they do in a clinic room. Patients consistently report improved understanding of their condition and greater confidence in self-management after completing the education sessions.
Exercise can be safely guided and monitored via video: Neuromuscular exercise the core of GLA:D®'s therapeutic approach does not require hands-on intervention. A trained physiotherapist can observe movement quality, provide real-time corrections, and progress or modify exercises through a screen with the same clinical rigour as an in-person session.
Consistency becomes easier: When patients can join a session from their living room, adherence improves. There is no travel time, no parking, no rescheduling because of transport. For a program that requires twice-weekly attendance over six weeks, that reliability has a direct impact on outcomes.
Rural and regional Australians can finally access the program: Prior to telehealth delivery, access to GLA:D® was effectively limited to areas with trained physiotherapists and clinic infrastructure. Remote delivery means that a patient in regional Queensland or outback New South Wales can access the same evidence-based program as someone in inner Melbourne.
Self-management is reinforced at home: Because patients exercise in their own environment, the habits they build during the program are more likely to persist. The exercises are not associated with a clinical setting — they become part of the patient's home routine from day one.
Who is the GLA:D® telehealth program suitable for?
GLA:D® via telehealth is appropriate for most people with hip or knee osteoarthritis symptoms, including those who are considering joint replacement surgery and want to explore conservative management first. It is particularly well-suited to:
Rural & regional
Australians who live far from physiotherapy clinics or have limited transport options
Older adults
Who find regular clinic attendance difficult due to mobility, transport, or time constraints
Chronic care
Patients on GP Management Plans or Team Care Arrangements referred for physiotherapy
Pre-surgery
Patients considering joint replacement who want to trial and maximise conservative management first
At Telephysio Australia, we provide telehealth physiotherapy for patients with hip and knee osteoarthritis across rural and regional Australia. For patients on chronic care plans — including GP Management Plans (GPMP), Team Care Arrangements (TCA), and Enhanced Primary Care (EPC) plans — we offer gap-free consultations under Medicare. There is no out-of-pocket cost for eligible patients.
Addressing the common concerns
Can a physiotherapist properly assess my movement through a screen?
Yes, with the right setup and a trained telehealth physiotherapist. Movement assessment via video is well-established in the research literature. Your physiotherapist will guide you through specific movements, observe your technique in real time, and gather the same clinically relevant information they would in a face-to-face setting. The GLA:D® telehealth research confirms that physiotherapist adopters found the format effective and clinically appropriate.
Is exercise via video call as safe as supervised in-person exercise?
The GLA:D® Australia telehealth evaluation found no indication that safety was compromised in the telehealth delivery model. Neuromuscular exercise for osteoarthritis is inherently low-risk, and a trained physiotherapist can monitor technique, load, and pain response via video just as effectively as in person. Exercises are always tailored to your individual capacity and progressed at an appropriate rate.
Will I get the same results as I would attending a clinic in person?
Based on the Ezzat et al. research, the clinical outcomes for telehealth GLA:D® are consistent with those seen in face-to-face delivery, moderate to large improvements in pain, function, and quality of life, with nearly two in three patients reaching a clinically meaningful improvement in quality of life. The satisfaction data is actually higher for telehealth-only delivery (99%) than for hybrid delivery (85%), suggesting the fully remote format works very well for patients who engage with it.
What do I need to participate?
A smartphone, tablet, or computer with a camera and a stable internet connection. You will need a space at home large enough to perform simple standing exercises, roughly the size of a yoga mat. No gym equipment is required; GLA:D® exercises are designed to use bodyweight and everyday movements. Your physiotherapist will walk you through the setup before your first session.
Is telehealth physiotherapy covered by Medicare for osteoarthritis patients?
Yes - if you have been referred by your GP under a chronic care plan (GPMP, TCA, or EPC), you are eligible for Medicare-subsidised physiotherapy. At Telephysio Australia, we provide gap-free consultations for eligible patients, meaning there is no out-of-pocket cost for your sessions. Speak to your GP about a referral if you have not yet been assessed under a chronic care management plan.
From doubt to confidence: what the evidence tells us
The initial scepticism around telehealth physiotherapy was reasonable. It was a new model, delivered differently, without the reassurance of physical presence. But the GLA:D® Australia telehealth research has done something important: it has taken that question out of the realm of opinion and answered it with data.
Ninety-nine percent of patients who completed GLA:D® via telehealth were satisfied or very satisfied. Nearly two in three reached a clinically meaningful improvement in quality of life. Pain reduced. Function improved. Confidence in self-management increased. And for patients in rural and regional Australia who previously had no viable access to structured osteoarthritis rehabilitation, this program is now reachable, from home, at no out-of-pocket cost for those on chronic care plans.
Telehealth physiotherapy is not a compromise. For many Australians, it is simply the better option.
References
Ezzat AM, Kemp JL, Heerey JJ, Pazzinatto MF, De Oliveira Silva D, Dundules K, Francis M, Barton CJ. Implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia: a mixed-methods program evaluation. Journal of Telemedicine and Telecare. 2025;31(1):104–120. doi: 10.1177/1357633X231167620
Barton CJ, et al. Program evaluation of GLA:D® Australia: Physiotherapist training outcomes and effectiveness of implementation for people with knee osteoarthritis. Osteoarthritis and Cartilage Open. 2021;3(3):100191.
Roos EM, et al. GLA:D® — Good Life with osteoArthritis from Denmark: evidence-based education and supervised neuromuscular exercise delivered by trained physiotherapists nationwide. BMC Musculoskeletal Disorders. 2021;22:1–12.
Withers HG, et al. Remotely delivered physiotherapy is as effective as face-to-face physiotherapy for musculoskeletal conditions (REFORM): a randomised trial. Journal of Physiotherapy. 2024;70(2):124–133.
All Telephysio Australia physiotherapists are registered with the Australian Health Practitioner Regulation Agency (AHPRA). Follow us on Instagram, Facebook, and LinkedIn @telephysioaus for the latest in telehealth physiotherapy research and practice.