Osteoarthritis is a common degenerative disease that significantly impacts mobility and disability in older adults. This pilot randomized controlled study aimed to examine the effects of a three-month resistance training program on lower limb muscular endurance, balance performance, pain, and quality of life among patients who had undergone unilateral total knee arthroplasty. Twenty-four participants were randomly assigned to either the experimental group receiving resistance training or the control group receiving routine postoperative rehabilitation. The study evaluates and compares the effectiveness of these interventions to provide insights into incorporating resistance training into postoperative nursing care and recovery programs.

This study employed an interventional, experimental design with a three-month follow-up to investigate the effectiveness of a progressive lower extremity resistance training program for patients with osteoarthritis following unilateral total joint arthroplasty. The study adhered to the CONSORT guidelines for reporting clinical trials.

Participants were randomly allocated into two groups:

1. Control Group: Received routine postoperative rehabilitation care.

2. Experimental Group: Received a progressive lower extremity resistance exercise program in addition to routine care. The program utilized 1-kg ankle weights and included seated knee extension, standing hamstring curls, and hip abduction. Training sessions were performed three times per week for three months, with the training volume progressively adjusted as follows:

   • 1st Postoperative Month: Performed on the non-operated limb only (2 sets per exercise).
   • 2nd Postoperative Month: Continued on the non-operated limb (3 sets) and introduced to the operated limb (2 sets).
   • 3rd Postoperative Month: Increased to 4 sets for the non-operated limb and 3 sets for the operated limb.

Each set consisted of 10 repetitions with a 1-minute rest between sets. Participants also received an illustrated exercise leaflet to enhance safety and adherence.

Inclusion Criteria:

• Diagnosis of osteoarthritis requiring first-time unilateral lower limb total joint arthroplasty
• No planned surgery on the contralateral limb
• Clear consciousness and ability to communicate in Mandarin or Taiwanese
• Independent ambulation before surgery
• Adequate vision and hearing (with correction if needed)
• Community-dwelling status
• Willing to participate in this study

Exclusion Criteria:

• Inability to ambulate independently
• Medical contraindications to exercise
• Severe musculoskeletal conditions other than osteoarthritis
• Same-day admission and surgery
• Bilateral joint arthroplasty