Eccentric vs Low-Load Blood Flow Restriction Training in Knee Osteoarthritis in Knee Osteoarthritis

Inclusion Criteria: * Age group 40-70 * Both genders male and female * Clinical diagnosis of knee OA (Kellgren-Lawrence grade 1-3) of the most symptomatic knee. * Pain stable enough to permit exercise on Numeric Pain Rating Scale 3/10. * Participants must demonstrate a gastrocnemius muscle strength of grade ≥3 on the Manual Muscle Testing (MMT) scale (0-5), assessed using the standard standing heel-rise position. * Participants must be able to ambulate independently and participate in supervised exercise. Exclusion Criteria: * • Presence of a prosthetic knee in the affected limb. * Inflammatory arthritis (e.g., rheumatoid arthritis) or active flare-up of OA. * Cardiovascular disease contraindicating exercise (e.g., unstable angina, recent MI, uncontrolled hypertension ≥160/100 mmHg). * Pulmonary disease that limits safe participation (e.g., severe COPD, recent exacerbation). * History of deep vein thrombosis (DVT), peripheral vascular disease, or bleeding/clotting disorders. * Current anticoagulant therapy that increases bleeding risk (unless cleared by physician). * Any pathology causing significant muscle weakness (e.g., neuromuscular disorders, severe neuropathy).