<b>Prevalence of Femoroacetabular Impingement Symptoms in Football Players with Chronic Adductor-Related Groin Pain</b>

Background: Knee osteoarthritis is a leading cause of disability, and obesity amplifies its impact by increasing joint loading, systemic inflammation, and cardiometabolic risk. Exercise therapy remains the cornerstone of conservative management, yet the optimal modality for obese patients with knee osteoarthritis remains uncertain, particularly regarding integrated effects on pain, function, psychological health, lipid metabolism, oxygenation, and neurotrophic response. Objective: To compare the effects of weight-bearing functional exercises, non-weight-bearing quadriceps strengthening, and breathing exercises on multidimensional outcomes in obese patients with knee osteoarthritis. Methods: In this randomized controlled trial, 108 participants were allocated equally to the three interventions for 12 weeks. Primary outcomes included pain intensity (NPRS) and functional status (WOMAC). Secondary outcomes comprised psychological health (DASS-21), lipid profile, arterial blood gases, and serum brain-derived neurotrophic factor. Data were analyzed using repeated measures ANOVA with post hoc tests, regression adjustment for confounders, and effect size calculations. Results: Non-weight-bearing quadriceps strengthening produced the greatest pain reduction (mean NPRS 2.8 ± 0.9), while breathing exercises demonstrated superior functional improvement (WOMAC 46.0 ± 7.8), greater psychological benefit (stress 7.8 ± 2.9), higher HDL (+3.6 mg/dL vs weight-bearing, p = 0.04), improved PaO₂ (+6.5 mmHg, p = 0.01), and elevated BDNF (+3.2 ng/mL vs non-weight-bearing, p = 0.002). Conclusion: Distinct exercise modalities confer differential benefits; non-weight-bearing exercise should be prioritized for pain management, whereas breathing exercises provide broader systemic and psychosocial gains, supporting personalized multimodal rehabilitation.