## 3 Results  
At baseline, the groups were homogeneous in terms of their sociodemographic characteristics (Table 1) and functional disability (Table 2). Initially, 99 subjects were assessed for eligibility, of which 60 were enrolled, and 13 participants withdrew for reasons unrelated to the research protocol (Figure 1). The recruitment and follow-up periods were between April 2023 and March 2024, with no adverse events (falls, fainting, nausea, or incapatitating pain) occurring, and adherence rates were 73.3% in the CG and 76.7% in the EG, respectively. The intragroup analysis shows that the EG had statistically significant improvements in WOMAC-pain (post-tests 1, 2, 3, and follow-up), WOMAC-stiffness (post-test 3), WOMAC-function (post-tests 1, 2, 3, and follow-up), and WOMAC-total (post-tests 1, 2, 3, and follow-up), with a moderate to large ES (d = 0.59 to 1.46). In contrast, the CG showed significant improvements only in WOMAC-function and WOMAC-total at post-test 3, with a moderate ES (d = 0.71 to 0.73). Additionally, the intergroup analysis indicates that at post-test 3, the EG outperformed the CG (\(p\) < 0.05) in WOMAC-pain, with a large ES (d = 1.46) (Table 2). The GRoC results showed that the mean score for the EG was categorized as a moderate favorable change, while the CG score indicated a small to moderate favorable change. The difference between groups was statistically significant (4.7 \(\pm\) 1.2 and 3.5 \(\pm\) 1.4 for the mean and the standard deviation of the EG and CG, respectively), with a large ES (d = 0.85). Figure 3 presents the \(\pm\)MCID thresholds for WOMAC scores, along with bars representing each participant's \(\Delta\) scores for their classification as Rs, NRs, or ARs. In the EG, the most frequent category was Rs, except for WOMAC-function, while in the CG, NRs were the most frequent. Compared to the CG, and except for WOMAC-function, the EG had higher frequencies of Rs, with a statistically significant difference in WOMAC-pain (\(\chi^{2}\) test, \(p<0.01\); z-test, \(p<0.01\)). For the NRs category, except for WOMAC-function, the EG had lower frequencies, with a statistically significant difference in WOMAC-pain (\(\chi^{2}\) test, \(p<0.01\); z-test, \(p<0.01\)). Finally, for the ARs category, the frequencies were lower in the EG, except for WOMAC-function, where they were the same between groups. Table 3 shows the frequency distribution of these categories in the study groups. Based on the 25 th, 50 th, and 75 th percentile values of the baseline WOMAC-total score, the quartile ranges were as follows: quartile 1 (Q1): 0 to 33 points; quartile 2 (Q2): 34 to 43 points; quartile 3 (Q3): 44 to 55 points; and quartile 4 (Q4): \(\geq\)56 points. At the end of the intervention, in the CG, 50% of participants were stratified within Q1, 20% in Q2, 20% in Q3, and 10% in Q4. According to interquartile flow (pre-test to post-test 3), 40% of participants remained in their initial quartile, 50% moved to a better quartile, and 10% shifted to a worse quartile. In the EG, 76.6% of participants were stratified within Q1, 16.6% in Q2, 3.3% in Q3, and 3.3% in Q4. According to interquartile flow, 23.3% of participants remained in their initial quartile, 70% moved to a better quartile, and 6.6% shifted to a worse quartile (Figure 4).