"Bimodal vs Unimodal High-Intensity Pulsed Electromagnetic Field Therapy in Older Adults With Knee Osteoarthritis"

Inclusion criteria

• Age ≥ 60
• Clinical and radiological diagnosis of knee OA grade I-IV
• Pain ≥ 3 on Numeric Analog Scale for \>6 months
• Can walk (with/without aid)
• Cognitive ability to follow instructions
• Signed informed consent
• Availability for 9 treatment sessions and home exercise

Exclusion criteria

• Prior total knee arthroplasty (unilateral or bilateral)
• Neurological disorders affecting motor function or cognition (e.g., Parkinson's disease, stroke, moderate to severe dementia)
• Active inflammatory rheumatic diseases (e.g., rheumatoid arthritis, lupus)
• Presence of pacemakers, implantable defibrillators, or metallic implants near the treatment area
• Current use of other physical therapy modalities for pain (e.g., electrotherapy, ultrasound, TENS) outside the study protocol
• Participation in another clinical trial within the past 3 months
• Current use of NSAIDs or systemic/local corticosteroids (including intra-articular injections)
• Open wounds or active infections at the treatment site
• Decompensated cardiac conditions or medical contraindication to exercise
• Vestibular disorders that affect balance and interfere with functional assessments
• Uncorrected visual impairment interfering with gait or balance (visual acuity worse than 20/60 in the better eye, assessed by Snellen chart)
• Withdrawal Criteria:
• Participants who complete fewer than 7 out of the 9 planned intervention sessions (i.e., less than 80% adherence)
• Occurrence of serious adverse events related to the intervention that contraindicate continuation
• Repeated non-compliance with the home exercise program, documented in at least two consecutive weekly follow-up reports
• Voluntary withdrawal of consent at any time during the study