Knee osteoarthritis is a prevalent musculoskeletal condition that significantly impacts mobility and quality of life. It is characterized by joint pain, stiffness, and functional impairment which often leads to reduced physical activity and increased disability. Conventional treatment approaches focus on pain management, physical therapy, and surgical interventions in severe cases. There is growing interest in biomechanical interventions aimed at modifying gait patterns to alleviate joint stress and slow disease progression. One such approach is toe out gait modification which involves externally rotating the foot during walking to alter load distribution within the knee joint. Previous studies have shown that toe out gait can reduce knee adduction moment and may have a protective effect against disease progression.

This study aims to evaluate the effectiveness of a 4 week toe out gait modification intervention in reducing pain and improving the quality of life in individuals with medial knee osteoarthritis.  The study population includes adults aged 45 to 70 years with unilateral medial knee osteoarthritis of Kellgren and Lawrence grade 1 and 2 who were able to walk independently. A total of 48 participants will be recruited and randomly allocated into two groups. Group A will receive toe out gait training along with conventional therapy while Group B will receive conventional therapy only. The intervention program will be conducted for 4 weeks with 4 sessions per week each lasting 40 to 45 minutes.

Outcome measures includes Numeric Pain Rating Scale NPRS, Western Ontario and McMaster Universities Osteoarthritis Index WOMAC, foot progression angle, and dynamic knee valgus. Data will be collected before and after the intervention and analyzed using appropriate statistical tests. The study is designed as a single blinded trial where participants were unaware of their allocation group.