Multimodal Physiotherapy Intervention in Grade III Knee Osteoarthritis in an Older Adult: A Case Report

Abstract

Background: Knee osteoarthritis is a common degenerative musculoskeletal disorder in older adults associated with pain, joint stiffness, muscle weakness, limited range of motion, and reduced functional ability. Physiotherapy plays an important role in symptom management and functional improvement.
Objective: This case report aimed to describe the short-term clinical outcomes of multimodal physiotherapy intervention in an elderly patient with grade III knee osteoarthritis.
Methods: This single-patient case report followed the CARE guideline framework and was conducted at RSUD Pandan Arang Boyolali between September and October 2025. A 73-year-old male patient with grade III right knee osteoarthritis received four physiotherapy sessions over four weeks. Outcome measures included the Visual Analogue Scale (VAS), goniometric assessment, Manual Muscle Testing (MMT), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Timed Up and Go (TUG) test.
Results: The intervention consisted of infrared therapy, Transcutaneous Electrical Nerve Stimulation (TENS), stretching exercises, quadriceps setting exercises, and hold-relax techniques. Pain intensity decreased from 3 to 2 for resting pain, from 5 to 2 for tenderness, and from 6 to 4 for movement pain. Knee range of motion improved from 0°–110° to 0°–125°. Muscle strength improved from 4-/5 to 4+/5 in knee flexion and to 5/5 in knee extension. WOMAC scores improved from 51 to 45, while TUG performance improved from 16 to 13 seconds.
Conclusion: Multimodal physiotherapy intervention showed potential benefits in reducing pain and improving functional outcomes in an elderly patient with grade III knee osteoarthritis.