Patients will be selected based on the inclusion and exclusion criteria. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Numeric Pain Rating Scale (NPRS) will be used to assess pain, function, and disability in

patients with knee osteoarthritis (OA).To evaluate endurance, the Fatigue Resistance Test and the Sit-to-Stand Test will be conducted to assess quadriceps and hamstring endurance, respectively. Patients will then be divided into two groups, with 35 patients in each group: 1.Control Group: This group will receive standard exercises formulated during a panel discussion among the clinical staff in the Physiotherapy Outpatient Department at SRM General Hospital. 2.Experimental Group: In addition to the same protocol as the control group, this group will receive hamstring and quadriceps endurance exercises. For hamstring endurance, the Nordic Hamstring Exercise will be administered. During the first five weeks, 2 sets of 5 repetitions will be performed. From the sixth week onwards, the number of sets will increase to 3, with repetitions gradually increasing each week. In this exercise, the patient, supported by a therapist from behind, will kneel with the knees flexed at 90 degrees, lean forward, and then push backward immediately. In addition to the Nordic Hamstring Exercise, the experimental group will use a cycle ergometer for 35 minutes, three times a week, for eight weeks. At the end of the intervention period, KOOS, as well as endurance tests for the hamstrings and quadriceps, will be conducted to evaluate the outcomes.