The diagnosis of KOA was confirmed for each patient based on their medical history report and a physical examination performed by physical therapists based on the clinical criteria of the American College of Rheumatology (1986)18). The inclusion criteria consisted of pain in the knee and three of the following conditions: 1) aged at least 50 years of age, 2) less than 30 min of morning stiffness, 3) crepitus on active motion, 4) bony tenderness, 5) bony enlargement, and 6) no palpable warmth of the synovium. The subjects who met the inclusion criteria were asked to join and had to sign an informed consent form before participation. All individuals were able to walk and were assessed for all measurements. Each of them received standard medical management of KOA from a local primary care unit.