PURPOSE: This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA). METHODS: This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI plus NM, MF plus NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF36, and balance with Biodex were evaluated before and after interventions. RESULTS: Within-group comparisons showed that NM plus MI, NM plus MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI plus NM group had a more significant effect on pain, function, and static balance than the MF plus NM group. Nevertheless, the MF plus NM group improved the quality of life better than the MI plus NM and NM groups (p < 0.05). CONCLUSION: Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.

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