Comparison of Short-term Effects of Extracorporeal Shock Wave Therapy, Low-level Laser Therapy and Pulsed Electromagnetic Field Therapy in Knee Osteoarthritis

Comparison of Short-term Effects of Extracorporeal Shock Wave Therapy, Low-level Laser Therapy and Pulsed Electromagnetic Field Therapy in Knee Osteoarthritis

120 patients with Kellgren-Lawrence grade 2-3 knee osteoarthritis will be randomized into four groups: Control group, Extracorporeal shock wave therapy (ESWT) (once a week for 3 sessions), Low-level laser therapy (LLLT) (twice a week for 8 sessions), and Pulsed electromagnetic field therapy (PEMF) (twice a week for 8 sessions), with 30 patients in each group. All participants will be instructed in a daily exercise program, including knee joint range of motion, stretching, and strengthening exercises (3×10 repetitions). Outcome measures, including the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-36 (SF-36), and Timed Up & Go (TUG) test, will be assessed at baseline after treatment and at 3rd month.

Inclusion Criteria:

• experiencing knee pain persisting for more than 6 months, radiological assessment confirming grade 2 and grade 3 knee osteoarthritis based on the Kellgren-Lawrence system
• no history of physical therapy or regular use of non-steroidal anti-inflammatory drugs (NSAIDs) within the last 6 months,
• absence of any pathology other than osteoarthritis that could cause knee pain,
• no lumbar spine or hip pathology that could refer pain to the knee,
• free from any conditions that would prevent participation in exercise or physical therapy
• willing to regularly participate the treatment programs were included in the study.

Exclusion Criteria:

• presence of a condition that impairs ambulation,
• a documented history of spinal stenosis,
• evidence of a neurological disorder based on medical history or physical examination,
• the existence of an inflammatory or metabolic disorder that could lead to secondary osteoarthritis,
• administration of intra-articular knee injections within the past year,
• use of NSAIDs, paracetamol or topical agents within the preceding week,
• a prior history of surgical intervention involving the knee joint.