The study will be conducted to compare effects of 9 points electrical dry needling along with standard physical therapy and standard physical therapy alone in knee osteoarthritis patients.
participants age group from 40-60 years
Both male and female genders
Knee osteoarthritis (OA) confirmed by radiographic evidence (Kellgren- Lawrence grade 3).
Numerical Pain Rating Scale (NPRS) ≥ 4/10.
Mild to severe knee osteoarthritis (Kellgren-Lawrence grade 2 or 4).
Recent knee surgery or injection (<6 months).
Knee instability and ligamentous injury.
Pregnancy and breastfeeding.
Parallel
9 points electrical dry needling
Other intervention9 points electrical dry needling, stainless steel dry needles of size 0.25 into 30mm will be used, inserted perpendicularly into popliteus, adductor magnus, tibialis anterior, quad tendon, vastus lateralis, medialis, medial \& lateral infrapatellar sulcus, extensor digitorum longus.
Standard physical therapy
Other interventionStandarized physical therapy: HOT pack for 5 min, hams \& quads stretching for 30 sec \& 6 reps, quads strengthening straight leg raise \& leg press will be performed 15 reps \& 3 sets, for hams seated leg curls \& gluteal bridges will be performed 15 reps \& 3 sets. MWM in weight bearing position: The glide will be applied in weight bearing, effected knee on stepper, the therapist will be exactly sitting in front of the patient \& patient will be asked to place the limb up on the stepper one hand of the therapist has to be on the lateral side of the tibia and other hand on the medial side of the femur \& now the patient will be asked to climb, therapist will apply medial \& lateral pressure 10 reps \& 3 sets.
Numeric Pain Rating Scale (NPRS)
Numeric Pain Rating Scale (NPRS) measures subjective pain intensity using an 11-point numeric scale (0-10) where 0 = "no pain" and 10 = "worst pain imaginable". Patients verbally or mark on a horizontal line the whole number best reflecting current pain severity, typically assessing "current pain," "worst pain," "least pain," or "average pain" over the prior 24 hours. Mild pain = 1-3, moderate pain = 4-6, severe pain = 7-10 guides clinical decision-making. changes in NPRS scale will be measured baseline and at the end of 6 week.
Goniometer measures joint range of motion (ROM)
Goniometer: Precision instrument measuring joint range of motion (ROM) in degrees using protractor body with two arms (stationary and movable) aligned to anatomical bony landmarks spanning the joint axis. Primary Use: Quantifies active (AROM) and passive (PROM) joint excursion for objective baseline, progress tracking, and impairment rating. Universal goniometer most common; digital/smartphone apps offer improved reliability (ICC \>0.9 vs 0.74-0.91 traditional). Reliability: Long-arm \> short-arm (MSD 6° vs 10°); inter/intra-rater ICC 0.84-0.99 with standardized technique. changes in knee flexion and extension ROM will be measured baseline and at the end of 6 week.
WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index)
WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) is a validated, disease-specific patient-reported outcome measure for hip/knee osteoarthritis assessing pain (5 items, 0-20), stiffness (2 items, 0-8), and physical function (17 items, 0-68) over past 48 hours. Scoring: Likert 0-4 scale per item (0=None, 4=Extreme); higher total scores (0-96) indicate worse symptoms. MCID: 12% improvement (\~9-12 points) represents clinically meaningful change. changes in WOMAC score will be measured baseline and at the end of 6 week.
EQ-5D 3L (QUALITY OF LIFE)
EQ-5D-3L is developed by EuroQol groups is standardized instrument for measurement of health-related quality of life. it administers strong test-retest reliability for knee OA which of 0.73 to 0.91. Changes in EQ-5D 3L will be measured at baseline and at 6 weeks.
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