Alpha-Music Entrainment Combined with Physiotherapy Improves Inflammatory and Functional Outcomes in Osteoarthritis of Knee: A Randomized Trial

Background: Osteoarthritis of the knee is a chronic degenerative condition characterized by pain, inflammation, stiffness, and functional limitations. Conventional physiotherapy plays a central role in its management; however, complementary neurosensory approaches such as alpha-music entrainment may enhance therapeutic outcomes by influencing pain perception, relaxation, and neurophysiological processes that regulate inflammation. Objective: To evaluate the effects of alpha-music entrainment, when combined with physiotherapy, on inflammatory markers and functional outcomes among individuals with knee osteoarthritis. Methods: A randomized controlled trial was conducted on 40 participants diagnosed with chronic osteoarthritis of the knee (Kellgren-Lawrence grade 2-3). Participants were randomly assigned to Group I (alpha-music entrainment + physiotherapy + electrical modalities) or Group II (physiotherapy + electrical modalities). Interventions were delivered five days a week for eight weeks. Outcome measures included FLIR infrared thermography, Visual Analogue Scale (VAS), Manual Muscle Testing (quadriceps and hamstrings), girth measurement, knee flexion range of motion, and Musculoskeletal Health Questionnaire (MSK-HQ). Assessments were recorded at baseline, 2 weeks, 4 weeks, and 8 weeks. Results: Both groups demonstrated statistically significant improvements over eight weeks (p < 0.05). However, Group I showed markedly greater reductions in surface temperature (mean difference 5.61°C), VAS (mean difference 8.95), swelling (mean difference 8.81 cm), and significantly higher gains in knee flexion, quadriceps and hamstring strength, and MSK-HQ scores compared to the control group (p < 0.001). Conclusion: Alpha-music entrainment combined with physiotherapy produced superior improvements in inflammation, pain reduction, muscle strength, and functional capacity than physiotherapy alone. Incorporating alpha-rhythm auditory stimulation may provide an effective adjunctive approach in the rehabilitation of knee osteoarthritis.