The NTU JO-SMART Study

Exclusion Criteria

• •KL grade 4 KOA in either knee.
• •Diagnosis of inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis.
• •Knee arthroscopy within the past 3 months or previous surgical history of TKA.
• •Recent receipt of intra-articular injections (e.g., corticosteroids, hyaluronic acid) within the past 3 months.
• •Documented history of osteoporotic fracture in hospital or cloud-based medical records.
• •Type 1 diabetes.
• •Presence of conditions precluding safe participation in an exercise program, such as unstable cardiovascular disease or severe neurological disorders.
• •Participation in another interventional clinical trial within the past 3 months.
• •Engagement in dietary regimens likely to cause significant weight change (e.g., intermittent fasting, such as the 16:8 time-restricted eating) within 1 month prior to trial initiation.
• •Use of any FDA-approved weight-loss medications (e.g., semaglutide, tirzepatide) within 3 months prior to trial initiation.
• •History of any form of surgical treatment for weight loss.
• •Current use of lithium or antipsychotics at a dose equivalent to olanzapine \>20 mg/day.
• •Pregnant or breastfeeding women, or women of childbearing potential without adequate contraception.
• •Current malignancy (within the validity period of a catastrophic illness certificate), or any other clinical condition deemed unsuitable for participation by the investigator (investigator discretion).
• •Inability to use smart devices or telecommunication tools due to severe visual/hearing impairment or lack of internet access.