We have had a few instances whereby participants are experiencing an increase in joint pain e.g. knees, hips and ankles, and they are attributing this pain to the PreFIT exercises and have sought Orthopaedic consultations. These instances have been thoroughly investigated and have been discussed with the participants' GP's who have felt this increase in longstanding joint pain (due to OA and other Orthopaedic conditions) is not due to the PreFIT exercise programme and the Orthopaedic reviews were due to their on-going problems not because of PreFIT. And as we all know, the evidence suggests that exercise is extremely important for those with arthritis and does not have a negative impact on the disease process and may in fact be beneficial (see Chapter 10 in your PreFIT exercise manual). Additionally, we know that the Otago programme is very well evidenced and researched. However, we are also very well aware that if a participant does blame the PreFIT programme for their increase in pain, this can be distressing and worrying for the therapists and participants involved and we want to minimise this as much as possible, but, if the participant wishes to withdraw from treatment for this reason, then they are absolutely entitled to do so. But if you have any concerns or queries, the PLEASE do call or email the PreFIT team with all of the details so we can discuss any concerns and give as much reassurance as possible and advise whether an adverse event form needs completing (see Chapter 11 in the PreFIT exercise manual).