الفهرس 
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Abstract
Abstract
Background and purpose: Osteoarthritis is a disease that accounts for most knee joint replacement surgeries and lost efficiency at work and is the most common cause of musculoskeletal pain and disability in adults. This study was designed to investigate the possible role of using natural environmentally selected herbal extracts mixture on managing physical disability caused by primary knee osteoarthritis. The selected herbal extracts were camphor, peppermint, ginger, clove, black seed, and garden cress oil extracts in ointment base. Subjects and method: 80 patients were recruited from the outpatient clinic at National Heart Institute and enrolled in this study. The patients were suffering from grade (C) knee osteoarthritis and had disability in daily living activities. They were divided randomly into two equal groups: in group (A), the patients were received physical therapy program for 12 sessions, in addition to applying a topical ointment containing the selected mixture of herbal oils, and they were instructed to rub the affected area with the ointment twice daily, and in group (B), the patients were received a physical therapy program and a placebo ointment. Assessment was done through patient data sheet which included dynamic pain assessment, active knee range of motion, knee muscles power and daily living activities questionnaire. Results: Statistical analysis revealed a significant reduction in dynamic pain during walking, upstairs, downstairs, and during standing from sitting. Range of motion of knee flexion and extension and muscles power of knee flexors and knee extensors showed a significant improvement of the group (A) in favor. Functional mobility, balance, daily living activities, and independent praying physical ability were improved in the group (A) compared to the group (B) as well. Conclusion: Using such mixture of herbal extracts in combination with regular physical therapy program can decrease dynamic knee joint pain, with increasing range of motion of knee flexion and extension, as well as knee flexors and extensors muscles power so that increasing the patient’s functional mobility, balance, daily living activities, and independent praying physical ability thus, decrease the physical disability and regain their health-related quality of life