Inclusion Criteria:  Subjects diagnosed with moderate unilateral knee OA according to the American College of Rheumatology criteria  Morning stiffness Crepitus on knee motion Bony tenderness No palpable warmth. a population of individuals (45-55 years old). patients are not obese their body mass index (BMI) will be> 30kg/ m2. with a diagnosis grade 2 radiographic severity according to the Kellgren/Lawrence scale. grading scale The severity of the disease was radiologically evaluated by an orthopedic knee specialist.  Exclusion Criteria:  Patients with the following criteria will be excluded from participating in this study:  if they had received an intra-articular injection of hyaluronic acid or corticoids during the six months prior to the study. if they had a clinical history of orthopedic knee surgery, a skin disorder. cardiovascular diseases, such as acute myocardial infarction, during the previous month, or uncontrolled arterial hypertension, acute-phase respiratory conditions. or if they had been receiving another kind of physiotherapeutic treatment.