Home-Based Leg Dexterity Trainer for Management of Knee Osteoarthritis - PROJECT SUMMARY Neuromuscular Dynamics, LLC has developed the Leg Dexerity System, a patented portable, wireless device for short-latency sensorimotor circuit neuromuscular training using unstable dynamic foot-ground interactions that can be utilized as nonsurgical management of knee OA to reduce pain and improve function. The Leg Dexerity System was designed to be used in a seated position that allows users to compress a platform atop a slender spring, which becomes unstable as it begins to buckle at low forces. Sustaining pressure while maintaining stability over the spring challenges and trains the user's proprioceptive and neuromuscular control, focusing specifically on the low-level circuitry essential for proper knee mechanics. The tablet computer connected to the device, linked to a HIPAA-compliant cloud platform, provides participants with feedback during use and uploads participant activity data to the server for analysis and reporting that is accessible to both participants and clinicians to inform continued care. This Direct-to-Phase II project primarily aims to clinically validate and enable a go-to-market strategy for the Leg Dexterity System as a home-based exercise device for the nonsurgical management of knee OA. This project will utilize a longitudinal blinded dose-matched trial comparing 8 weeks of leg dexterity training (Treatment using a slender, unstable spring that engages short-latency sensorimotor control, 42 participants) vs. stable leg presses (Placebo using wider, stable spring, 42 participants) at the Steadman Philippon Research Institute. The project envisions the system being used in about 1,600 clinics, representing around 3% of physical therapy clinics in the United States, within five years. This adoption is projected to improve care for OA patients and generate clinic income through billable Remote Therapeutic Monitoring (RTM) by integrating a robust, remote, industry-standard clinical UI/UX that clinicians can use to improve their remote care and grow their RTM revenue.