Comparative Efficacy of Interferential Therapy and Ultrasound Combined with Knee Exercises vs. TENS with Knee Exercises in Grade 3–4 Knee Osteoarthritis: A Six-Month Randomized Controlled Trial

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Vol. 13 No. 3 (2025): 2025 Volume -13 - Issue 3

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September 4, 2025
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Comparative Efficacy of Interferential Therapy and Ultrasound Combined with Knee Exercises vs. TENS with Knee Exercises in Grade 3–4 Knee Osteoarthritis: A Six-Month Randomized Controlled Trial

S. Purna Chandra Shekhar
Professor, School of Physiotherapy and Rehabilitation, MNR University, Sangareddy, Telangana, India.
T. Rajeswari
Associate Professor, Devs Homoeopathy Medical College, KNR University of Health Sciences, Telangana, India
Pothunoor Harish Kumar
Prinicpal, Sanjeevani College of Physiotherapy, KNRUHS, Sangareddy, Telangana, India.
N. Shirisha Devi
Professor, School of Physiotherapy and Rehabilitation, MNR University, Sangareddy, Telangana, India.
BNS. Gayatri
Associate Professor, KIMS College of Physiotherapy, KNRUHS, Telangana, India
Ravi Shankar Ravi
Department of Physiotherapy, Capital University, Koderma, Jharkhand, India
Divyasree
Associate Professor, Vidyanath Institue of Physiotherapy, MUHS, Parli Vaijanath, Maharastra.
Venu Gopal Pawar
College of Physiotherapy, Deccan College of Medical Sciences, KNRUHS, Telangana, India

Corresponding Author(s) : S. Purna Chandra Shekhar

purnaptphd@gmail.com

International Journal of Allied Medical Sciences and Clinical Research, Vol. 13 No. 3 (2025): 2025 Volume -13 - Issue 3

Abstract

Background: Severe knee osteoarthritis (OA), classified as Kellgren-Lawrence (KL) grades 3-4, significantly impairs mobility and quality of life. Non-pharmacological interventions, including electrotherapy modalities, are increasingly utilized to manage symptoms. This study evaluates the comparative efficacy of interferential therapy (IFT) combined with ultrasound (US) and knee exercises versus transcutaneous electrical nerve stimulation (TENS) with knee exercises in patients with advanced knee OA.


Methods: A prospective, single-blind, randomized controlled trial was conducted with 50 participants diagnosed with KL grade 3–4 knee OA. Participants were randomized into two groups: Group 1 received IFT and US combined with knee exercises, while Group 2 received TENS with knee exercises. Outcomes assessed at baseline, 3 months, and 6 months included pain (Visual Analog Scale, VAS), function (Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC), knee range of motion (ROM), and quality of life (Short Form-36, SF-36).


Results: Group 1 demonstrated statistically significant improvements in WOMAC scores (Δ = 15.2, p < 0.001) and VAS scores (Δ = 3.1, p = 0.002) compared to Group 2 at 6 months. Additionally, ROM and SF-36 physical component scores favored Group 1 (p < 0.05).


Conclusion: The combination of IFT and US with knee exercises significantly outperforms TENS with exercises in managing severe knee OA, supporting their integration into rehabilitation protocols.

Keywords

Knee Osteoarthritis Interferential Therapy Therapeutic Ultrasound Transcutaneous Electrical Nerve Stimulation TENS Physiotherapy Randomized Controlled Trial Pain Management Range of Motion WOMAC VAS Non-Pharmacological Treatment
1.
S. Purna Chandra Shekhar, T. Rajeswari, Pothunoor Harish Kumar, N. Shirisha Devi, BNS. Gayatri, Ravi Shankar Ravi, et al. Comparative Efficacy of Interferential Therapy and Ultrasound Combined with Knee Exercises vs. TENS with Knee Exercises in Grade 3–4 Knee Osteoarthritis: A Six-Month Randomized Controlled Trial. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2025 Sep. 4 [cited 2025 Sep. 20];13(3):522-7. Available from: https://ijamscr.com/ijamscr/article/view/1664
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