Introduction
Osteoarthritis, OA, chronic disability, pain, reduced pain, articular disease
OSTEOPHYTES, OSTEOARTHRITIS, INFLAMMATION, DEGENERATIVE, PATHOGENESIS, ARTICULAR DISEASE
Osteoarthritis (OA) is one of the most prevalent degenerative conditions resulting in disability, particularly among the elderly population. OA is the most common articular disease in the developed world and a leading cause of chronic disability, primarily due to knee OA and hip OAWomen are particularly susceptible to OA, accounting for approximately 60% of all OA patientsThe pathogenesis of knee OA involves a complex interplay of mechanical, genetic, and biochemical factors. It typically begins with cartilage degradation, leading to changes in the subchondral bone, inflammation, and alterations in joint tissues. As the cartilage wears down, the joint space narrows, bone spurs (osteophytes) may form, and the synovium (joint lining) may become inflamed. These processes collectively contribute to pain, stiffness, and functional limitations associated with knee OAStrength training exercises effectively manage knee OA by improving muscle strength and function, thereby reducing pain and enhancing quality of lifeStrengthening exercises and vagal nerve stimulation are noninvasive interventions that can be implemented without the need for medications or surgical procedures. This makes them attractive treatment options for individuals with grade II knee OA who prefer a conservative approach or have contraindications for other treatments. Combining strengthening exercises with polyvagal exercises may offer potential synergistic effects in the management of OA symptoms. Strengthening exercises can help improve joint stability, reduce stress on the joint, and enhance overall physical function. Vagal nerve stimulation techniques following polyvagal exercises may help regulate autonomic function, reduce pain perception, and promote relaxation and emotional well-being. This study hypothesized that the combination of these interventions would lead to improved overall outcomes for individuals diagnosed with grade II knee OA.Based on the above, the primary objective of this study was to investigate the potential benefits of combining strengthening exercises with polyvagal theory–based exercises as a noninvasive intervention for females diagnosed with grade II knee OA. Specifically, we aimed to assess whether the synergistic effects of these interventions could lead to improved joint stability, reduced pain perception, enhanced autonomic regulation, and improved overall physical function and emotional well-being among females with Grade II knee OA.