Effects of Agility and Perturbation-Based Training in Addition to Routine Physical Therapy on Pain, Function, and Quality of Life in Patients with Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis is a highly prevalent degenerative joint disease that causes progressive pain, stiffness, instability, and disability, leading to impaired quality of life. Conventional physiotherapy reduces symptoms but often fails to adequately address proprioceptive and neuromuscular deficits that contribute to functional limitations. Agility and perturbation-based training have been proposed as adjunctive strategies to enhance dynamic stability and functional recovery. Objective: To evaluate the effects of agility and perturbation-based training, in addition to routine physiotherapy, on pain, function, disability, and quality of life in patients with knee osteoarthritis. Methods: A randomized controlled trial was conducted on 30 patients with radiographically confirmed grade II–III knee osteoarthritis, allocated to either control (routine physiotherapy) or intervention (routine physiotherapy plus agility and perturbation training) groups. Each group received three supervised sessions per week for four weeks. Outcomes were assessed at baseline and post-intervention using NPRS, WOMAC, KOS-ADLS, and SF-36. Data were analyzed with paired and independent t-tests. Results: Both groups improved significantly across all outcomes (p < 0.001). Between-group comparisons favored the intervention, with greater reductions in pain (Δ–0.70, p = 0.01), disability (Δ–6.00, p < 0.001), and superior gains in function (Δ+14.23, p < 0.001) and quality of life (Δ+18.50, p < 0.001). Conclusion: Agility and perturbation training, when added to physiotherapy, produced significantly greater improvements in pain, function, disability, and quality of life compared with physiotherapy alone, supporting its integration into comprehensive rehabilitation protocols.