Inclusion criteria: age 45-70 years, bilateral knee OA(grade 1,2 and 3), both genders (male and female), cartilage degeneration, local biomechanical factors (e.g., joint deformity, muscle weakness), nutritional factors, postmenopausal women,
and exclusion criteria: grade 4, neurological disorders (e.g. Alzheimer’s disease, Parkinson’s disease), knee replacement, rheumatoid arthritis, steroidal injection in the past 2 months, neuropathy, tumor, knee fractures, knee ligament or meniscus injury, a congenital disorder of knee, diabetes mellitus > 10 years, metal implants in the knee.