to investigate the effect of adding Reflexlogy to mulligan mobilization and the conventional treatment for patients with Osteoarthritis knees

Knee osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. Treatment by reflexology stimulation increases blood flow to the associated organ or body part. On the other hand, the nerve impulse theory claims that reflexology stimulation boosts nervous connection to the conforming body parts. Regarding to the energy theory; organs and body parts are connected through electromagnetic fields and that these pathways are blocked in states of disease. Finally, lactic acid theory pointed that lactic acid accumulates on the soles of the feet in the form of crystals which promotes free circulation, so reduces regular flow .The effects of foot reflexology on improving physical complains of KOA. Therefore, this study was conducted to evaluate the effectiveness of reflexology foot massage on pain intensity and physical functional abilities among patients with Knee Osteoarthritis.

Mulligan's Mobilization with Movement (MWM) advocates therapist-applied accessory gliding force combined with active movement The goal of MWM is to achieve immediate pain relief possibly by regulation of the non-opioid pain sensory pathways and by correction of micro positional faults. These positional faults may result from changes in the shape of articular surfaces, cartilage thickness, fiber orientation in the capsule-ligamentous complex, and the direction of musculo-tendinous pull, causing altered mechanics in the osteoarthritic knees.

Inclusion Criteria:

1. Age greater than or equal to 40 years.
2. Body Mass Index ≤30 kg/m².
3. All participants have Calcium Deficiency
4. Osteoarthritis in mild and moderate stage not in the acute stage
5. The subjects were chosen from both genders

Exclusion Criteria:

1. Deep Vein Thrombosis

2. Fractures

3. Gangrena Patient

4. Osteopenic Patient

5. Lactating or pregnant women

6. Cancer

7. Neurological conditions.

8. Patients with injury including; (lesions, sprain, open wounds, foot ulcer and or burn of the lower extremities), hemorrhage, epilepsy, irregular heartbeat.

9. Vascular (Anticoagulant Therapy, Aortic Aneurysm)

10. Neurological Deficits (multilevel PIVD, Cervical Myelopathy)

11. Psychological Disorders.

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