Background: Knee osteoarthritis (KOA) is a prevalent chronic musculoskeletal disorder associated with pain, reduced mobility, impaired physical function, and disability. Conventional rehabilitation primarily focuses on the knee and proximal lower-limb musculature. The foot, however, represents the distal segment of the kinetic chain, and intrinsic foot muscle function and foot core stability may influence lower-limb alignment and knee loading.

Objective: To evaluate the effect of combined intrinsic foot muscle strengthening and foot core stabilization training on knee joint loading and functional outcomes in individuals with knee osteoarthritis.

Methods: Sixty individuals with clinically and radiographically confirmed Grade II–III KOA were recruited using convenient sampling and randomly allocated to Group A (control group; n=30) or Group B (experimental group; n=30). Both groups received a conventional knee exercise protocol. The experimental group additionally received intrinsic foot muscle strengthening and foot core stabilization training. The study duration was six months. The reported outcomes were the Knee Abduction Test, Timed Up and Go (TUG) Test, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pre- and post-intervention data were analyzed using paired-sample t-tests for within-group comparisons and independent-sample t-tests for between-group change-score comparisons.

Results: Both groups demonstrated statistically significant pre- to post-intervention improvement in all three reported outcomes (p<0.0001). Group B demonstrated greater improvement than Group A. Knee Abduction Test scores improved by 3.47 kg in Group A and 6.50 kg in Group B. TUG time decreased by 1.97 seconds in Group A and 5.83 seconds in Group B. WOMAC scores decreased by 8.27 points in Group A and 18.43 points in Group B. Between-group comparisons were statistically significant for the Knee Abduction Test (t=-9.71, p<0.0001), TUG (t=16.98, p<0.0001), and WOMAC (t=16.33, p<0.0001).

Conclusion: According to the reported study findings, both interventions improved functional outcomes, while the group receiving the additional intrinsic foot muscle strengthening and foot core stabilization program demonstrated significantly greater improvement. Foot-focused rehabilitation may therefore be considered as an adjunct to conventional physiotherapy in individuals with KOA.