"Bimodal vs Unimodal High-Intensity Pulsed Electromagnetic Field Therapy in Older Adults With Knee Osteoarthritis"

Inclusion Criteria: * Age ≥ 60 * Clinical and radiological diagnosis of knee OA grade I-IV * Pain ≥ 3 on Numeric Analog Scale for \>6 months * Can walk (with/without aid) * Cognitive ability to follow instructions * Signed informed consent * Availability for 9 treatment sessions and home exercise Exclusion Criteria * Prior total knee arthroplasty (unilateral or bilateral) * Neurological disorders affecting motor function or cognition (e.g., Parkinson's disease, stroke, moderate to severe dementia) * Active inflammatory rheumatic diseases (e.g., rheumatoid arthritis, lupus) * Presence of pacemakers, implantable defibrillators, or metallic implants near the treatment area * Current use of other physical therapy modalities for pain (e.g., electrotherapy, ultrasound, TENS) outside the study protocol * Participation in another clinical trial within the past 3 months * Current use of NSAIDs or systemic/local corticosteroids (including intra-articular injections) * Open wounds or active infections at the treatment site * Decompensated cardiac conditions or medical contraindication to exercise * Vestibular disorders that affect balance and interfere with functional assessments * Uncorrected visual impairment interfering with gait or balance (visual acuity worse than 20/60 in the better eye, assessed by Snellen chart) Withdrawal Criteria: * Participants who complete fewer than 7 out of the 9 planned intervention sessions (i.e., less than 80% adherence) * Occurrence of serious adverse events related to the intervention that contraindicate continuation * Repeated non-compliance with the home exercise program, documented in at least two consecutive weekly follow-up reports * Voluntary withdrawal of consent at any time during the study