## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline \multirow{2}{*}{**Variable**} & \multirow{2}{*}{**Group**} & \multicolumn{3}{c}{**Before**} & \multicolumn{3}{c}{**After**} \\  & & **Mean \(\pm\) SD** & **Median** & **Range** & **p\({}^{\ddagger}\)** & **Mean \(\pm\) SD** & **Median** & **Range** & **p\({}^{\ddagger}\)** & **p\({}^{\ddagger}\)** \\ \hline \multirow{3}{*}{WOMAC} & E & 41.8 \(\pm\) 138 & 41.0 & 19.0–65.0 & & 36.4 \(\pm\) 14.1 & 39.0 & 08.0–58.0 & \multirow{3}{*}{0.01} \\  & MT & 48.2 \(\pm\) 19.6 & 47.0 & 2.0–81.0 & \textless{}0.01 & 41.0 \(\pm\) 28.8 & 32.0 & 1.0–84.0 & \textless{}0.01 \\  & C & 19.7 \(\pm\) 19.3 & 12.5 & 2.0–78.0 & & 19.0 \(\pm\) 20.6 & 11.0 & 1.0–75.0 & \textless{}0.01 \\ \hline \multirow{3}{*}{VAS left} & E & 4.9 \(\pm\) 2.7 & 5.5 & 0.0–10.0 & \multirow{3}{*}{0.96} & 2.5 \(\pm\) 2.1 & 2.5 & 0.0–6.0 & \multirow{3}{*}{0.67} & \textless{}0.01 \\  & MT & 4.9 \(\pm\) 2.5 & 5.0 & 0.0–8.0 & & 3.1 \(\pm\) 2.7 & 3.0 & 0.0–8.0 & \multirow{3}{*}{0.34} & \textless{}0.01 \\ \hline \multirow{3}{*}{VAS right} & E & 5.0 \(\pm\) 2.6 & 5.0 & 0.0–10.0 & \multirow{3}{*}{0.09} & 2.8 \(\pm\) 2.0 & 3.0 & 0.0–6.0 & \multirow{3}{*}{0.34} & \textless{}0.01 \\  & MT & 4.8 \(\pm\) 2.5 & 5.0 & 0.0–8.0 & & 3.2 \(\pm\) 2.7 & 3.0 & 0.0–8.0 & \multirow{3}{*}{0.34} & \textless{}0.01 \\ \hline \multirow{3}{*}{p\({}^{\ddagger}\)—intergroup WOMAC and VAS pre-treatment comparison (Kruskal–Wallis test or Mann–Whitney U test); p\({}^{\ddagger}\)—intergroup WOMAC and VAS post-treatment comparison (Kruskal–Wallis test or Mann–Whitney U test); p\({}^{\ddagger}\)—intergroup WOMAC and VAS pre- and post-treatment comparison (dependent Student’s \(t\)-test or * Wilcoxon signed-rank test).} & & & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Results of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) measures in Exercise (E), Manual Therapy (MT), and Control (C) groups of participants. We have observed that improvement of the range of knee flexion in the manual therapy group was not significant in the maximum squat test. We believe that this could be due to an absent therapeutic intervention in the hip. A positive effect of such a therapy on knee motion has been shown experimentally by [PERSON] et al. [33]. However, the squat depth is affected not only by the range of motion without pain, but also by coordination and muscle strength, which was certainly important in the manual therapy-only group. The second group performed lower limb exercises in the closed kinematic chain. The main aim was to enhance the strength of the muscles acting on the whole lower limb, including the quadriceps, and thus improve the ROM. [PERSON] et al. [19] basing on their results conclude that the decreased ROM is primarily caused by joint pain and a weak quadriceps. They believe that the tissues that surround the joint may become fibrotic, contracted, or shortened due to progressively lower mobility. Therefore, abnormalities develop in the articular capsule and the ROM decreases. We have seen in our results that the range of motion evaluated in the prone position in the open chain framework did not improve in such patients, but the maximum squat range did improve. We believe that our exercise regimen improved muscle strength and proprioception, and the patients were able to achieve a greater squat depth. It seems that the ability to maximize squat depth without pain will be much more useful to patients than the range of motion evaluated in the open chain in terms of activities of daily living. Other authors show that squatting is used when sitting down and getting up from a chair, crouching or using the toilet [34; 35]. No positive effect in terms of the range of motion in the prone position has been observed in the exercise group, possibly because no techniques were applied to relax soft tissues and involve joint mobilization. Other exercises confirmed to be effective in improving the range of motion include stretching and strengthening exercises.