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Effects of Eight Weeks of Conventional Corrective Exercises and Corrective Games on Agility, Power, and Dynamic Balance in Male Students with Genu Varum
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Saeed Shahrani *1    , Mohammad Rabiei2 |
1- Master's Degree in Sports Pathology and Corrective Movements, Shahrekord University, Shahrekord, Iran. , saeedshahrani1375@gmail.com
2- Assistant Professor, Department of Sports Biomechanics, Shahrekord University, Shahrekord, Iran. |
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Keywords: Genu Varum [MeSH], Students [MeSH], Sports Medicine [MeSH]
Article ID: Vol27-33 |
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Type of Study: Original Articles |
Subject:
Rehabilitation
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Abstract: (4 Views) |
Extended Abstract
Introduction
The lower limbs are considered fundamental components of an individual's postural alignment. Genu varum is a structural misalignment of the lower leg in the frontal plane. In this condition, while bearing weight on the lower limbs, the medial femoral condyles deviate laterally from one another when the medial malleoli are in contact.
Genu varum stems from various etiologies, including heredity, osteoporosis, growth plate injuries, muscular paralysis, osteoarthritis, asymmetrical bone growth around the knee joint, ruptures of the knee capsule and lateral ligaments, weakness of the lateral muscles (such as the biceps femoris, tensor fasciae latae, and peroneal muscles), and shortening of the medial muscles (including the semitendinosus, semimembranosus, gracilis, and tibialis anterior), as well as running and playing football, may contribute to this condition. Genu varum can significantly impact physical fitness indices, leading to fatigue, pain, instability, impaired postural control (balance), and diminished agility and power.
Physical fitness indices are categorized into two primary groups: Health-related physical fitness and skill performance-related physical fitness. Skill performance-related physical fitness is associated with the development and maintenance of factors that facilitate the execution of physical activities like sports. Among these factors are balance, agility, and power. The aforementioned deformity is characterized by alterations in postural control quality and the displacement of the center of gravity, or the mechanical axis of the lower limb, from the center of the knee joint toward the medial aspect. Such shifts can ultimately impair the individual’s balance indices and increase the risk of falls. Furthermore, during running, the load transmitted to the medial plateau is approximately 2.5 times greater than that exerted on the lateral plateau; in individuals with moderate genu varum, this load is nearly 3.3 times higher.
The significance of genu varum is amplified during childhood and adolescence, a critical period for musculoskeletal growth and development; therefore, paying attention to correcting abnormalities during this stage is an unavoidable necessity. Corrective strategies primarily include conventional corrective exercises and corrective games. The corrective exercise approach addresses malalignments by balancing agonist and antagonist muscle groups through strengthening and stretching exercises, a method widely utilized in research. However, this approach can be monotonous, potentially reducing patient adherence and endurance throughout the corrective intervention.
Another method employed in developed societies for correcting abnormalities is game exercise intervention. Given the child’s inherent inclination toward games and their enthusiastic engagement in physical activities during such sessions, corrective objectives can be achieved more effectively. Incorporating the game into corrective exercise programs promotes neuromuscular coordination, strengthens the musculoskeletal system, enhances cardiorespiratory function, and fosters long-term motivation for physical activity with reduced perceived exertion.
This study was conducted to determine the effects of eight weeks of conventional corrective exercises and corrective games on agility, power, and dynamic balance in male students with genu varum.
Methods
This field trial was conducted on 42 male students, aged 10–13 years, with genu varum.
Prior to the commencement of the study, the research procedures and objectives were explained to the students and their parents, and written informed consent was obtained from the parents. Subsequently, all participants completed a personal demographic questionnaire.
To assess the degree of genu varum during the pretest and posttest phases, the distance between the femoral intercondylar distances was measured while the medial malleoli were in contact (without any unusual muscle contraction or tension). Measurements were performed using an Iranian-made R150 model caliper with an accuracy of 0.05 mm. Genu varum was diagnosed based on a femoral intercondylar distance exceeding 2 cm.
To evaluate agility, power, and dynamic balance, the 4×9 meter shuttle run test, Sargent jump test, and Y-balance test were employed during the pretest and posttest phases, respectively.
Participants were assigned to one of three groups (n = 14 per group) using a simple randomization method: A control group (no intervention), a conventional corrective exercises group (a selected program consisting of 7 exercises), and a corrective games group (a selected program consisting of 4 games).
The conventional corrective exercises group and the corrective games group performed the exercise protocol for eight weeks, consisting of three 60-minute sessions per week. Each session included a 10-minute warm-up, 45 minutes of the exercise program, and a 5-minute cool-down. The difficulty, intensity, and volume of the protocol were progressively increased throughout the sessions. Meanwhile, the control group received no intervention and maintained their daily activities.
The corrective games protocol consisted of 4 games, while the conventional corrective exercises protocol included 7 corrective exercises.
The Kolmogorov-Smirnov test was employed to assess the normality of the distribution for quantitative variables (agility, power, and dynamic balance) across each group (control, conventional corrective exercises, and corrective games). Additionally, analysis of variance (ANOVA) and the least significant difference (LSD) post-hoc test were utilized. The difference between the pretest and posttest mean scores for each group was calculated as the rate of improvement.
Results
Following the eight-week exercises protocol, genu varum improved across all intervention groups. The mean improvement in the correction of genu varum was 10.57 mm in the corrective games group and 5.43 mm in the corrective exercises group (P<0.001). Furthermore, a statistically significant difference was observed between the two intervention groups, i.e., conventional corrective exercises and corrective games, favoring the corrective games group (P<0.001).
In the pretest phase, no significant statistical differences were observed between the three groups regarding the variables of power, agility, and dynamic balance in the dominant leg. However, the posttest results revealed significant statistical differences between the groups across all variables: Power (P<0.003), agility (P<0.001), and dynamic balance (P<0.009) in the dominant leg. To eliminate the baseline differences in pretest scores, the mean difference between pretest and post-test scores was calculated as the improvement rate. No significant changes were observed in the control group. The agility variable improved by averagely 0.90 seconds in the corrective exercises group and 0.73 seconds in the corrective games group. The power variable showed a mean improvement of 1.35 cm in the corrective exercises group and 1.97 cm in the corrective games group. Regarding dynamic balance in the dominant leg, the mean improvement was 0.35 cm in the the corrective exercises group and 0.27 cm in the corrective games group. Both intervention groups demonstrated statistically significant improvements in agility, power, and dynamic balance in the dominant lower limb compared to the control group (P<0.05). However, no statistically significant difference was observed between the two intervention groups in terms of the magnitude of improvement in these indices.
Conclusion
According to the findings of this study, the correction rate of genu varum deformity was significantly higher in the corrective games group compared to the corrective exercises group. However, no statistically significant difference was observed between the two intervention groups regarding the improvement of agility, power, and dynamic balance in the dominant lower limb.
The results indicated a significant impact of genu varum deformity on power and agility; specifically, these two variables improved following the correction of the deformity. The observed improvements in these variables can be attributed to the restoration of knee alignment to its neutral position and the more efficient and normalized activation of the periarticular muscles.
The corrective exercises protocol demonstrated a 2.62% greater efficacy compared to the corrective games protocol in improving dynamic balance. Biomechanical alterations resulting from the disruption of natural anatomical alignment impact joint feedback, proprioceptive receptors, or both, within the hip and knee joints; consequently, this leads to modifications in stability and reflexive behaviors of these joints. As a result, stability control, neuromuscular function, and proprioception in the knee joint are significantly diminished in individuals with genu varum.
Deficits in postural balance among individuals with genu varum can be attributed to several factors, including the malalignment of the joint (biomechanical alterations), neuromuscular dysfunction, imbalances in the strength ratios of the periarticular muscles, and impaired stimulation of proprioceptors around the knee. Consequently, balance in these individuals can be enhanced through postural correction of the knee, which leads to improved performance of the surrounding musculature and sensory receptors, thereby facilitating more effective neuromuscular coordination and proprioceptive feedback within the joint.
Ethical Statement
This study was approved by the Research Ethics Committee at Shahrekord University (IR.SKU.REC.1401.002).
Authors' Contributions
Saeed Shahrani (M.Sc): Project administration and design, Project execution, Data collection, Interpretation of the results, Drafting of the initial manuscript, Approval of the final manuscript.
Mohammad Rabiei (Ph.D): Project administration and design, Data analysis, Interpretation of the results, Approval of the final manuscript.
Conflicts of Interest
No conflicts of interest.
Acknowledgement
This study has been derived from the Master’s thesis of Mr. Saeed Shahrani (approval code: 170/1221) in Sports Pathology and Corrective Exercises at Shahrekord University. The authors would like to thank the participants, the students' parents, and the principals of school in Koohrang County for their invaluable cooperation in this study.
Key Message: Both interventions, i.e., conventional corrective exercises and corrective games, culminated in a relative correction of genu varum and a significant improvement in agility, power, and dynamic balance of the dominant leg. However, the effect of corrective games on the correction of genu varum was more substantial. |
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| References |
1. Karamvisi H, Babakhani F, Barati A. [The Effect of Genu Varum on the Pre-activation، Muscle Activation Pattern and Time to Stabilization During the Single Leg Jump-Landing]. JPSR. 2020;8(4):63-76. https://doi.org/10.22038/jpsr.2020.36185.1876. [Article in Persian] [ Link] [ DOI] 2. Arshadi R, Ghasemi GA, Samadi H. Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Phys Ther Sport. 2019 May;37:113-19. https://doi.org/10.1016/j.ptsp.2019.03.008. [ DOI] [ PubMed] 3. Yalfani A, Givaki M, Ashoury H. [Comparison of the Effect of Two Kinds of the Common and the NASM Corrective Exercises on the Changes of Genu Varum Deformity and Balance of Adolescent Soccer Players; A mixed method study]. JQRHS. 2019; 8(2):14-30. [Article in Persian] [ Link] 4. Hosseini R, Norasteh AA, Nemati N. [Comparing the Balance of Male Athletes Aged 11-14 Years With and Without Genu Varum]. J Sport Biomech. 2019;4(4):54-65. http://dx.doi.org/10.32598/biomechanics.4.4.54. [Article in Persian] [ Link] [ DOI] 5. Tajdini Kakavandi H, Sadeghi H, Abasi A. [Investigating Ground Reaction Forces and Electromyography Muscle Activity of Lower Extremity During the Stance Phase of Walking in Active Male with and Without Genu Varum Deformity in Kharazmi University in 2017: A Descriptive Study]. JRUMS. 2019;18(7):675-88. [Article in Persian] [ Link] 6. Daneshmandi H, Alizadeh MH, Gharakhanlou R. [Corrective Exercises]. 17th ed. Tehran: SAMT Publication. 2019. [Persian] 7. Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy. 2007 Dec;23(12):1320-1325.e6. https://doi.org/10.1016/j.arthro.2007.07.003. [ DOI] [ PubMed] 8. Messier SP, Martin DF, Mihalko SL, Ip E, DeVita P, Cannon DW, et al. A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS). Am J Sports Med. 2018 Jul;46(9):2211-21. https://doi.org/10.1177/0363546518773755. [ DOI] [ PubMed] 9. Melekoglu T, Isin A. The Relationship between Football Participation Level and Lower Leg Alignment in Youth Males: Genu Varum. J Educ Train Stud. 2019;7(2):137-41. https://doi.org/10.11114/jets.v7i2.3955. [ Link] [ DOI] 10. Sheikh M, Shahbazi M, Tahmasbi SH. [Measurement and Evaluation in Physical Education and Sports Sciences]. 15th ed. Tehran: Bamdad Book. 2022; pp: 153-57, 197, 207. [Persian] 11. Rajabi R, Samadi H. [Laboratory of corrective movements]. 14th ed. Tehran: University of Tehran. 2020; pp: 63, 144. [Persian] 12. Momenifar F, Raji A, Jafarnezhadgero AA, Yousefi Bilehsavar O, Yarahmadi J. [The Effect of Ramadan Fasting Combined With Regular Aerobic Exercise on Cortisol Level and Trait-State Anxiety in Female Professional Athletes]. SJRM. 2000;11(3):320-31. https://doi.org/10.32598/SJRM.11.3.7. [Article in Persian] [ Link] [ DOI] 13. Mongashti Joni Y, Fatahi F, Ghanizadeh Hasar N, Hosseinpour E. Effect of Genu Varum Deformity on Gluteus Medius Muscle Activity and Postural Control During Single-Leg Jump-Landing. PTJ. 2017;7(2):79-88. http://dx.doi.org/10.32598/ptj.7.2.79. [ Link] [ DOI] 14. Bakhtiary AH, Fatemi E, RezaSoltani A. [Genu varum deformity may increase postural sway and falling risk]. Koomesh. 2012;13(3):e152518. [Article in Persian] [ Link] 15. Jafarnezhadgero A, Zivari M. [Effect of fatigue protocol on lower limb muscle activities in individuals with genu varus during running with agility shoes]. Studies in Sport Medicine (SMJ). 2020;12(28):55-70. https://doi.org/10.22089/smj.2021.10190.1469. [Article in Persian] [ Link] [ DOI] 16. Daneshmandi H, Rezazadeh F, Aali Sh, Khodadad B. [The Relationship between Posture and Physical Fitness in Blind, Deaf and Normal Children]. Med J Tabriz Uni Med. 2016;38(2):28-35. [Article in Persian] [ Link] 17. Tavana Kermani M, Ebrahimi Atri A, Khoshraftar Yazdi N. [The Effect of Eight Weeks Corrective Exercise on the Functional Kyphosis Curvature in the Teenager Girls]. SJRM. 2017;6(1):161-68. https://doi.org/10.22037/jrm.2017.1100275. [Article in Persian] [ Link] [ DOI] 18. Soleimani H. [Comparison of the effects of two common corrective exercise methods and corrective games on the degree of scoliosis curvature in 10- to 13-year-old girls]. Thesis. Shahrekord University. 2016. [Persian] 19. Kuo MS, Chuang TY. How gamification motivates visits and engagement for online academic dissemination – An empirical study. Comput Human Behav. 2016; 55(Part A): 16-27. https://doi.org/10.1016/j.chb.2015.08.025. [ Link] [ DOI] 20. Tavana Kermani M, Ebrahimi Atri A, Khoshraftar Yazdi N. [The Effect of Eight Weeks Corrective Exercise on the Functional Kyphosis Curvature in the Teenager Girls]. SJRM. 2017;6(1):161-68. https://doi.org/10.22037/jrm.2017.1100275. [ Link] [ DOI] 21. Jafarzadeh H, Fouladi R, Fallah Mohammadi M. [Effect of Six Weeks of Exercise With Traband on the Dynamic Balance of 15-17 Years Old Soccer Players With Genu Varum Deformity]. SJRM. 2022;11(4):576-89. https://doi.org/10.32598/SJRM.11.4.4. [Persian] [ Link] [ DOI] 22. Ghasemi B, Shahrani Z. [Corrective movements (with the approach of corrective games)]. 1st ed. Esfahan: University Jihad. 2013; pp: 106-11. [Persian] 23. Rajabi R, Bayat Turk M, Mozafaripour I, Alaffan N, Mousavi SH. [Preventive and corrective games for musculoskeletal disordersin children]. 1st ed. Tehran: University of Tehran. 2020; pp: 133-43. [Persian] 24. Khosravi MT. [Investigating the relationship between lower limb abnormalities and some physical fitness factors]. Thesis. Faculty of Physical Education and Sports Sciences. Gilan University. 2012. [Persian] [ Link] 25. Emarati FS, Namazizadeh M, Mokhtari F, Mohammadian F. [Effects of selected elementary school games on the perceptual-motor ability and social growth of 8-to-9 year-old female students]. JRRS. 2011; 7(5): 661-73. [Article in Persian] [ Link] 26. Ghanizadeh Hesar N, Ebrahimi B, Zolnoor Z. [The effect of corrective exercises on the static balance of athletes and non-athletes with knee braces]. The first national conference on physical education and school sports in the country. Urmia. 2014. [Persian] 27. Mirzadeh Moghaddam A, Soltandost Nari SM, Khoshraftar Yazdi N. [Investigating static balance and lower extremity kinematics during Walking in patients with Genuvarum]. SJRM. 2015;4(4):148-55. https://doi.org/10.22037/jrm.2015.1100230. [ Link] [ DOI] 28. Yahyaiarad M. [A study of knee misalignment and dynamic balance in female athletes]. Thesis. Faculty of Physical Education and Sports Sciences. Gilan University. 2012. [Persian] [ Link] 29. Samaei A, Bakhtiary AH, Elham F, Rezasoltani A. Effects of genu varum deformity on postural stability. Int J Sports Med. 2012 Jun;33(6):469-73. https://doi.org/10.1055/s-0031-1301331. [ DOI] [ PubMed] 30. Ghodsinezhad Kalahrodi O, Piri H, Ebrahimi E. [The Effect of Eight Weeks of Corrective Games on the Functional Assessment, Navicular Drop Index, and Balance in Male Students Aged 9 to 12 with Flexible Flatfoot]. J Clin Res Paramed Sci. 2025;14(1):e157990. https://doi.org/10.5812/jcrps-157990. [Article in Persian] [ Link] [ DOI] 31. Ghiami Rad A, Fattahi Turki A, Shahbazi B. [Comparison of the Effectiveness of Two Corrective Exercise Methods (NASM) and Corrective Games on Genu Varum in Boys Aged 10-12]. J Sport Biomech. 2023;9(2):128-38. http://dx.doi.org/10.61186/JSportBiomech.9.2.128. [Article in Persian] [ Link] [ DOI] 32. Ahmadnezhad L, Ebrahimi- Atri A, Khoshraftar-Yazdi N, Sokhangoei Y. [Research Paper: Effect of Eight Weeks Corrective Games on Kyphosis Curve and Strengths of Trunk Muscle in Kyphotic Mentally Retarded Children]. JREHAB. 2016;17(2):178-87. http://dx.doi.org/10.21859/jrehab-1702178 [Article in Persian] [ Link] [ DOI] |
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Shahrani S, Rabiei M. Effects of Eight Weeks of Conventional Corrective Exercises and Corrective Games on Agility, Power, and Dynamic Balance in Male Students with Genu Varum. J Gorgan Univ Med Sci 2025; 27 (4) :25-34 URL: http://goums.ac.ir/journal/article-1-4577-en.html
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