Intermittent Hypoxia-Hyperoxia Combined With Physical Therapy for Knee Osteoarthritis

This randomized controlled trial aims to evaluate the effectiveness of combining intermittent hypoxia-hyperoxia therapy (IHHT) with conventional physical therapy in improving pain, function, gait, balance, and general health among patients with knee osteoarthritis. The study will be conducted at the Physical Therapy Department of Rehman Medical Institute, Peshawar, Pakistan, over a period of one year.

Inclusion Criteria: * Participants aged 45 and above. * Participants (both male and female) with knee pain for 3 months or more with any three of the following six items: age of 50 years or more, crepitations, enlarged bone, no palpable warmth, morning stiffness for less than 30 minutes, and bony tenderness. * Patients who can walk and have a minimum score of 4 on the Numeric Pain Rating Scale. * Participants who have intact cognition with a score of 24 and above on Mini Mini- Mental State examination. * Participants able to walk independently for at least 45 meters in the 6-minute walk test. * Participants having a recent X-ray (done within the past 3 months). Exclusion Criteria: * Patients with hip or knee arthroplasty. * Participants with above or below knee surgery or radiating pain to the lower limb. * Patients with history of epilepsy, pregnancy * Diagnosed neurological condition that affects lower-limb strength or walk (e.g., stroke/ basal ganglia dysfunction/ trauma) * Patients who refused to participate in the study or to be randomly allocated. * Patients receiving steroids or any medicine other than that prescribed by the screening orthopaedic surgeon.