2.1. Study design
KOA
RECRUITMENT, RHEUMATIC DISEASES
In this randomized controlled clinical trial, the patients who were diagnosed with KOA were assigned to 3 groups. The patients in the experimental group engaged in a 2-month program of HBE with cryotherapy. The patients in the first control group received only HBE for 2 months, while those in the second control group received regular therapeutic and physiotherapeutic services at the center.The patients in all 3 groups received education about the risk factors of KOA based on the center regulations. The patients who attended the center were screened medically and clinically for eligibility. Those diagnosed with KOA by a rheumatologist in the center met the initial eligibility criteria for this study and were referred to the researchers at the center. The researchers measured the patient body mass index (BMI), checked other eligibility criteria, and received written consent from those who met the eligibility criteria for the next step. The patients were then randomly assigned to the experimental, control, or second control groups (see flow chart in Fig. Flowchart of patients’ recruitment.The patients were recruited from the Specialized Center of Rheumatic Diseases and Medical Rehabilitation in Duhok City in Iraqi Kurdistan between August 1