One hundred three patients with symptomatic knee Osteoarthritis (OA) meeting National Institute for Health and Care Excellence (NICE) clinical criteria were randomized to receive a telehealth PT (Physical Therapy) intervention with strengthening, education, and step goals delivered in five Zoom sessions over 12 weeks (n=51) or access to a study website with publicly available OA resources (n=52). The primary outcome was change in Moderate- to vigorous-intensity physical activity (MVPA) (ActiGraph GT3X) at 12 weeks. Secondary outcomes included light-intensity physical activity, steps/day, treatment beliefs about exercise/PT, and MVPA at 24 weeks; exploratory outcomes included knee pain (VAS) and KOOS subscales at 12 and 24 weeks. Outcomes were assessed at baseline, 12, and 24 weeks. Overall, the results revealed no between-group difference in MVPA at 12 weeks, nor in light activity or steps/day, while the intervention improved negative treatment beliefs and showed superiority for pain, function, and quality of life at several time points. In conclusion, adding step goals to a telehealth PT exercise/education program did not increase MVPA versus web resources, although pain and function benefits were observed.