Exercise-based Cardiac Rehabilitation in Congestive Heart Failure With Coexisting Knee Osteoarthritis

Exclusion Criteria

• •Presence of severe comorbid conditions that could interfere with the study protocol or pose a risk to the patient, such as severe pulmonary disease, advanced renal or liver disease, or active malignancy.
• •Kellgren-Lawrence grade IV knee OA or recent knee surgery within the last 6 months.
• •Presence of inflammatory arthritis, such as rheumatoid arthritis or gout
• •Recent myocardial infarction (within the past 3 months), unstable angina, or recent coronary artery bypass graft surgery.
• •Any condition that contraindicates exercise participation, such as severe hypertension (BP \> 180/110 mmHg), uncontrolled arrhythmias, or severe aortic stenosis.
• •Significant cognitive impairment or psychiatric disorder that would interfere with adherence to the exercise protocol.
• •Patients already participating in regular, structured exercise programs exceeding moderate intensity (\>150 minutes per week)