Effects of acupuncture, physiotherapy and exercise training on knee arthrosis

INTERVENTION: Intervention 1: The acupuncture group (A): acupuncture at selected acupoint for knee pain, 3 sessions per week for 4 weeks. Intervention 2: The physical modality group (B): TENS (transcutaneous electrical nerve stimulation), ultrasond and hot pack at pain areas, 3 sessions per week for 4 weeks. Intervention 3: The exercise group (C):isometric exercise of the knee, 3 sessions pr week for 4 weeks. Rehabilitation The acupuncture group (A): acupuncture at selected acupoint for knee pain, 3 sessions per week for 4 weeks The exercise group (C):isometric exercise of the knee, 3 sessions pr week for 4 weeks The physical modality group (B): TENS (transcutaneous electrical nerve stimulation), ultrasond and hot pack at pain areas, 3 sessions per week for 4 weeks. CONDITION: Knee Osteoarthritis. ; Other primary gonarthrosis Other primary gonarthrosis PRIMARY OUTCOME: Pain, symptoms, and activities of daily living. Timepoint: Before and after treatment. Method of measurement: Koos questionnare. Pain. Timepoint: Before and after treatment. Method of measurement: Visual Analogue Scale (VAS). INCLUSION CRITERIA: INCLUSION CRITERIA: 1‐Male and female with knee pain lasting for 6 months or longer 2‐Age between 40‐65 years 3‐Normal neurological examination 4‐At least one osteophyte at tibiofemoral joint (Kellgren‐ Lawrence grade >2) 5‐Not receiving intra articular injection from 3 months ago 6‐ Not consuming NSAIDs during last week before study 7‐No history of knee surgery 8‐No history of treatment with acupuncture 9‐No history of cancer, pregnancy and secondary osteoarthritis. Exclusion criteria: 1‐Low adherence to treatment 2‐Receiving NSAIDs during study 3‐Exacerbation of symptoms.