Background: Knee osteoarthritis is a highly prevalent chronic condition that affects approximately 80% of individuals aged ≥ 65 years. Major problems include pain, dysfunction, reduced quality of life, balance ability, and muscle tone. Objects: This study examined the effects of multidirectional knee-strengthening exercises using elastic bands on knee pain, functional disability, quality of life, balance ability, and rectus femoris (RF) muscle tone in elderly patients aged ≥ 65 years with knee osteoarthritis. Methods: Forty-eight patients aged ≥ 65 years with knee osteoarthritis participated in the study. The participants were assigned randomly to either the experimental group (n = 24) or the control group (n = 24). Both groups performed knee-strengthening exercises, but the experimental group incorporated elastic bands into their exercises. All interventions were conducted 3 times a week for 30 minutes per session over 4 weeks. The effects were assessed before and after the intervention using the Numeric Rating Scale (NRS), Korean version of the Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), Euro Quality of Life 5 Dimension (EQ-5D), Berg Balance Scale (BBS), and RF muscle tone. Between-group differences before and after the intervention were analyzed using the independent t-test, and withingroup differences were examined using the paired t-test for pre-post intervention comparisons of the dependent variables. Results: Both groups showed significant improvements in the NRS, K-WOMAC function, KWOMAC total score, EQ-5D, BBS, and RF muscle tone after the intervention (p < 0.05). In addition, the experimental group showed significant improvements in the NRS, K-WOMAC, BBS, and RF muscle tone compared with the control group (p < 0.05). Conclusion: Multidirectional knee-strengthening exercises using elastic bands can be an effective intervention to improve knee pain, functional disability, balance ability, and RF muscle tone in elderly patients aged ≥ 65 years with knee osteoarthritis.

INTRODUCTION
MATERIALS AND METHODS
    1. Participants
    2. Study Design
    3. Interventions
    4. Assessment Methods
    5. Statistical Analysis
RESULTS
DISCUSSION
CONCLUSIONS
FUNDING
ACKNOWLEDGEMENTS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTION
ORCID
REFERENCES

• Sang-woo Yoon(Department of Physical Therapy, Graduate School, Daejeon University)
• Suhn-yeop Kim(Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Daejeon, Korea) Corresponding author