Comparison of three different therapeutic interventions in the management of knee osteoarthritis: Randomized controlled parallel group pilot trial.

Objective: The study aimed to compare the effectiveness of different physical interventions on pain intensity, knee function, and quality of life in patients with knee osteoarthritis (OA). Methods: This pilot trial involved 63 patients (45-55 ​yrs) in a rehabilitation center. Patients were randomly assigned to three groups: therapeutic exercise alone (TE, n ​= ​21), TE and cryotherapy (TE-Cr, n ​= ​21), and TE and joint mobilization (TE-JM, n ​= ​21). The primary outcome was pain intensity, secondary outcomes included knee joint function (WOMAC), muscle strength, knee joint range of motion (ROM), and quality of life (SF-36). Data were collected at baseline and after 18 days of inpatient rehabilitation. Results: There were no significant between-group differences in the primary outcome at baseline. After 18 days, all intervention groups showed significant improvements (p ​< ​0.05). The TE-JM group reported lower (p ​< ​0.05) pain levels (3.24 ​± ​1.04) compared to the TE-only (4.76 ​± ​0.77) and TE-Cr (4.86 ​± ​0.57) groups. The TE-Cr group had a lower (p ​< ​0.05) SF-36 total score (52.81 ​± ​10.50) than the TE (62.00 ​± ​9.74) and TE-JM (66.62 ​± ​2.87) groups. No significant between-group differences were observed in ROM or muscle strength. The WOMAC total score was lower (p ​< ​0.05) in the TE-JM group (27.3 ​± ​13.9) compared to the TE-Cr group (40.1 ​± ​10.7). Conclusion: Although all three interventions had beneficial short-term effects, leading to reductions in knee pain and improvements in physical function and quality of life, but no single intervention demonstrated superior effectiveness across all assessed outcomes. Trial registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT05636059.