Knee osteoarthritis (KOA) is a degenerative joint disease causing pain, stiffness, and reduced quality of life. While treatments often focus on drugs or surgery, noninvasive exercises like core stabilization and ankle/foot strengthening show potential but lack comparative studies. Understanding anatomical factors like Achilles tendon (AT) thickness is crucial for targeted rehabilitation, though measurement reliability remains an issue. This study aims to compare the effects of these exercises on KOA symptoms and evaluate the use of digital calipers for AT thickness measurement, aiming to enhance clinical management of KOA.

The objective of the study is:

1. To determine the interrater and intrarater reliability of digital calliper to measure the side to side Achilles tendon thickness.
2. To determine the impact of 24 sessions of core stability translated in gait ambulation.
3. determines the relationships between Achilles tendon thickness (ATT), knee symptoms/functions, and foot alignment in knee OA patients, considering their interconnected biomechanical nature.
4. compare the effects of core stability and ankle-foot strengthening exercises on clinical outcomes in KOA patients

Inclusion Criteria:

• 40 years old, had been diagnosed with KOA based on ACR, and

  • having Grade II or III osteoarthritis by K/L criteria.

Exclusion Criteria:

• post-traumatic osteoarthritis
• lower limb sensorimotor dysfunction,
• Any history of knee fracture/ tumor/ infection and hip/knee surgery.
• Total Knee Replacement patients.
• Neurological disease.
• Patient received physical therapy treatment from last 6 months.
• Inflammatory Arthritis (Rheumatoid Arthritis)
• Use of any intra-articular injections (steroid/ hyaluronic acid/ PRP.) from last 3-6 months.