Abstract
BACKGROUND: Exercise program and dietary supplements are commonly used in the conservative management of knee osteoarthritis (KOA) and have both been shown to reduce pain and improve physical function. Combining these approaches may offer additive benefits or introduce specific adherence challenges from the patient perspective. The combination of structured exercise with dietary supplements remains underexplored, especially through qualitative approaches. This study aims to investigate the lived experiences, perceived benefits, challenges, and motivational factors among participants of a targeted exercise program combined with dietary supplementation. METHODS: A qualitative study design with three focus group was used to explore participants overall experiences, motivational factors, and barriers to participation immediately after program. The sample included 16 older adults with KOA (Kellgren-Lawrence grade 1-3, 14 women and 2 men). Two moderators facilitated each focus group using topic guide. Data were analysed using inductive thematic analysis. RESULTS: Six main themes were identified: (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. CONCLUSIONS: Participants' experiences with the combined exercise and dietary supplementation program for KOA highlighted the importance of social support, professional guidance, and self-motivation. Barriers included physical limitations, time constraints, and psychological challenges, while reported benefits included reduced pain, improved mood, and enhanced social engagement. Participants' tendency to perceive exercise and supplementation as separate components indicates that, in practice, combined interventions may function as parallel rather than integrated strategies unless explicitly framed and supported as a unified approach. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06269549. Registered on 13th February 2024.