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

Summary

This randomized, double-blind clinical trial aims to evaluate the effect of high-intensity pulsed electromagnetic field therapy (HI-PEMF) applied either exclusively on the knee joint or bimodally on the knee and quadriceps, in older adults with knee osteoarthritis. Both groups will also receive a structured home-based exercise program. The primary outcome is pain reduction, and secondary outcomes include functional performance.

Eligibility

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

Conditions5

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