This study aims to address this gap by comparing the effects of sensory-motor training versus resistance training on pain, balance and functional activities, specifically in patients with early-stage knee osteoarthritis. In Pakistan, Knee Osteoarthritis is a common condition that significantly impacts many individuals' quality of life. While research exists on various exercise interventions for knee osteoarthritis, there is limited focus on patients with Grade 1 and 2 osteoarthritis. Understanding the most effective training method for this group will provide valuable insights for developing targeted rehabilitation programs, ultimately improving patient outcomes and quality of life.

Osteoarthritis of the knee is a degenerative condition that gradually affects the synovial joints. Following the stress, joint become damaged and unable to repair and is triggered by asymmetry in synovial tissues of joint such as articular cartilage, ligaments, subchondral bone, periarticular musculature, menisci, synovia or peripheral nerves. This structural harm leads to the breakdown of subchondral bone and cartilage, resulting in symptoms like stiffness, pain, and limited range of motion. It is just like a plane surface of road becoming uneven and pitted. Osteoarthritis of knee joint debilitates the individuals and they totally rely on others.

Interventions for treating knee osteoarthritis include pharmacological and therapeutic technique. Present clinical recommendations in grade 1 and 2 favor conservative management, like physical therapy, use of assistive devices and weight management due to their simplicity, minimal side effects, and more economical. Due to extensive evidence showing the positive impact of physical activity on individuals with osteoarthritis, exercise is frequently recommended as a key element in the rehabilitation journey.

In various physical workout plans, muscle strengthening holds significance due to the connection between pain, muscle weakness, and limited function. Yet, standard strengthening routines might not suffice for individuals having functional joint instability. A research study on this specific group of patients explored treatments targeting symptoms directly, aiming to enhance the efficiency of the rehabilitation regimen. Recently awareness has been given by focusing on sensory inputs such as balance and proprioception exercises. It may allow individual to adapt motor skills for dealing with disability on knee. Sensorimotor training is an effective treatment to restore motor programs in patients among different musculoskeletal disorders and chronic musculoskeletal pain. It adopts a phase-oriented treatment approach and consists of regulation of arousal, emotion and behavior.

The goal of sensorimotor therapy training in knee osteoarthritis is to gain functional activities, relieve pain. As osteoarthritis advances, sensory-motor abilities like neuromuscular control, static and dynamic balance, and proprioception decrease due to reduced daily physical activities and heightened pain perception. Therefore, incorporating agility, coordination, and balance exercises such as cross steps while walking backward, walking on unsymmetrical surfaces and verbal commands by therapist can be beneficial by challenging individuals with disruptive loads. This exposure helps the neuromuscular system adapt to situations that may trigger knee instability during daily activities. Resistance training refers to a workout method where muscles are engaged against a resistance or weight. This training approach aids in strength enhancement, muscle building, and endurance improvement. It encompasses utilizing weights, resistance bands, or engaging in bodyweight exercises. The benefits of resistance training include overall fitness enhancement, bone density improvement, metabolism boost, and better physical performance. Proper execution of resistance training is crucial to prevent injuries and optimize workout effectiveness

Inclusion Criteria:

• Both males and females are included.
• Age group include 40-60 years.
• Not done any exercise for at least 3 months
• Tibiofemoral osteoarthritis
• Grade I and II osteoarthritis

Exclusion Criteria:

• • Cardiorespiratory diseases.

  • Uncontrolled diabetes and Hypertension.
  • Using ambulatory devices.

the outcome assessor remained blinded throughout the study, conducting assessments without knowledge of group allocation.