To evaluate the effect of Mulligan's mobilization with movement in osteoarthritis of the knee.

Patients with knee OA diagnosed at the orthopaedic clinic of Tumair general hospital and referred to the physiotherapy department who attended the rehabilitation centre of Majmaah university will be recruited.

Patients will be excluded if they have had a knee or hip injury, sensory deficits in the lower extremity, a history of lower-extremity surgery, a history of a quadriceps or hamstring muscle injury, low back-related leg pain, or any contraindication to manual therapy.

The protocol was submitted to and approved by the Rehabilitation Research Chair, King Saud University Research Ethics Committee (RRC-2021-17)

Participants will be requested to sign a written informed consent form approved by the institutional ethics committee. A total of 60 participants were randomly assigned to group A (experimental group): Mulligan's mobilization with movement MWM added isometric strength training, and group B (control group): Sham MWM added isometric strength training. Pre and post-test readings were taken at baseline, week 2, and week 4, respectively. The outcome measures for this study will be maximal voluntary isometric contraction of quadriceps strength (measured by ISOMOVE dynamometer), ROM, and Western Ontario and McMaster universities osteoarthritis (WOMAC) index.

Inclusion Criteria:

• Patient with knee OA with radiological evidence of grade 2 or 3 of the Kellgren and Lawrence scale.
• Age between 40-65 years, unilateral or bilateral involvement (in the case of bilateral involvement, the more symptomatic knee was included), and pain in and around the knee.

Exclusion Criteria:

• Patient will be excluded, if they had any deformity of the knee, hip, or back, had any central or peripheral nervous system involvement.
• They had received steroids or intra-articular injection within the previous three months, uncooperative patients.

Data will be kept secure with the principal investigator (Dr. Shahnaz Hasan) and sub-investigator (Dr. Naiyer Shahzad) due to confidentiality issues.