Multimodal Treatment of Knee Osteoarthritis: Therapeutic Exercise and Noninvasive Neuromodulation (NESA) Versus Therapeutic Exercise and Transcutaneous Electrical Nerve Stimulation (TENS) in People Over 60 Years of Age.

To analyze the effects of therapeutic exercise combined with noninvasive neuromodulation (NESA) or transcutaneous electrical nerve stimulation (TENS) on improving clinical symptoms such as joint pain and stiffness, as well as its impact on the functionality, mental health, and quality of life of people over 60 years of age with knee osteoarthritis.

Inclusion Criteria: * Individuals over 60 years of age. * Diagnosis of knee osteoarthritis in at least one knee according to the clinical criteria of the American College of Rheumatology. * Ability to walk independently without the need for assistive devices. * No medical contraindications to physical exercise or the application of noninvasive neuromodulation (NESA). * Ability to understand and sign the informed consent form to participate in the study. Exclusion Criteria: * Present medical contraindications to physical exercise or the application of noninvasive neuromodulation (NSA) (pacemaker, epilepsy, internal bleeding, acute febrile processes, acute thrombophlebitis, and/or phobia of electricity). * Present active oncological diseases or systemic autoimmune diseases. * Present severe psychiatric or neurological disorders that limit understanding and collaboration in treatment. * History of any surgery or fracture of the affected lower limb in the last 3 months. * Presence of severe gait or balance difficulties that impede the performance of the proposed exercises. * Simultaneous participation in other clinical trials.