This study aims to compare two different physiotherapy approaches for people suffering from Grade II Knee Osteoarthritis (OA) - a condition that causes knee pain, stiffness, and difficulty in walking.

The first approach is the Stanley Paris Manual Therapy Concept, which involves hands-on treatment techniques such as joint mobilization, soft tissue massage, and movement correction. The second is Conventional Physiotherapy, which uses traditional exercises and electrotherapy (like heat, ultrasound, or TENS) to reduce pain and improve strength.

The study will include 50 patients aged 40-60 years who have moderate knee osteoarthritis. They will be randomly divided into two groups - one receiving manual therapy and the other receiving conventional physiotherapy - for 6 to 8 weeks.

Researchers will measure pain, knee function, range of motion, balance, and quality of life before and after treatment to see which method gives better results.

By identifying which therapy works more effectively, this study will help patients, families, and healthcare providers choose the most beneficial and evidence-based treatment for improving movement, reducing pain, and enhancing daily living activities in people with knee osteoarthritis.

Knee osteoarthritis (OA) is a common degenerative joint disorder that causes pain, stiffness, and loss of mobility, often leading to functional limitations and reduced quality of life. In Grade II OA, cartilage damage is moderate and potentially reversible through appropriate rehabilitation strategies. This stage offers an important opportunity for physiotherapy interventions to restore function and delay further joint deterioration.

The Stanley Paris Manual Therapy Concept emphasizes a biomechanical and hands-on approach to rehabilitation. It includes joint mobilization, soft tissue manipulation, neural mobilization, and correction of faulty movement patterns to restore normal joint motion and neuromuscular control. In contrast, Conventional Physiotherapy typically focuses on pain management using electrotherapy modalities, strengthening exercises, and general mobility training.

This randomized controlled trial (RCT) is designed to compare the effectiveness of these two treatment approaches in individuals with Grade II knee osteoarthritis. Fifty participants will be randomly allocated into two equal groups: one receiving the Stanley Paris manual therapy and the other receiving conventional physiotherapy, for a period of 6-8 weeks. Standardized assessment tools - including the Visual Analog Scale (VAS) for pain, the Knee Injury and Osteoarthritis Outcome Score (KOOS) for function and quality of life, and the Berg Balance Scale for proprioception and stability - will be used to evaluate outcomes at baseline, mid-intervention, and post-intervention.

The study will generate clinical evidence on whether manual therapy provides superior outcomes in terms of pain relief, functional improvement, and patient satisfaction compared to conventional physiotherapy. Results are expected to assist clinicians in developing more effective rehabilitation protocols for managing knee osteoarthritis and improving patients' independence and overall well-being.

Inclusion Criteria:

• diagnosed with Grade II knee osteoarthritis based on radiographic and clinical criteria.
• Participants experiencing knee pain for at least three months.
• Ability to walk independently without assistive devices.
• Willingness to participate in a structured physiotherapy program.

Exclusion Criteria:

• Presence of Grade III or IV knee osteoarthritis.
• History of knee surgery or joint replacement.
• Rheumatoid arthritis or other inflammatory joint diseases.
• Neurological conditions affecting lower limb function.
• Contraindications to manual therapy or exercise interventions.

De-identified individual participant data (IPD) that support the results of this study - including demographic data, baseline characteristics, intervention details, and outcome measures (VAS, KOOS, Range of Motion, and Berg Balance Scale scores) - may be shared. No personally identifiable information will be disclosed. Data will be available upon reasonable request from qualified researchers for academic or clinical research purposes following publication of the main study results.

February 2026

On demand IPD will be shared with journals editor

This study will use a quadruple-blind design in which the participants, care providers, investigators, and outcomes assessors will all be masked to group allocation. Randomization will be conducted using a coded allocation system managed by an independent coordinator. Intervention protocols will be standardized and labeled by code to ensure blinding of treatment identity. Data collection and analysis will be performed without revealing group assignments to maintain objectivity and reduce bias.