Effects of a neuromuscular exercise program on lower limb alignment and balance ability in individuals with genu varum and knee pain.

Abstract

This study examined the effects of a neuromuscular exercise program on knee joint alignment, pain, and static and dynamic balance in patients with genu varum. Forty female patients aged 40-60 years with radiographically confirmed genu varum and a Short-Form McGill Pain Questionnaire (SF-MPQ) score ≥18.0 were randomly assigned to either an exercise group (EG, n=20) or a control group (CG, n=20). The EG participated in a supervised neuromuscular exercise program 3 times per week for 12 weeks (60 min/session), while the CG maintained usual daily activities. Radiographic assessments included knee-to-knee length (KTKL), hip inclination angle (HIA), and medial proximal tibial angle (MPTA). Pain was evaluated using the SF-MPQ. Static and dynamic plantar pressure were measured using a pressure analysis system. Data were analyzed using two-way mixed analysis of variance to examine interactions, with Bonferroni correction applied for post hoc analyses (P<0.05). Significant interactions were observed for KTKL, bilateral HIA, bilateral MPTA, and pain scores (all P<0.001). The EG demonstrated reductions in KTKL (-1.09 cm) and pain (-8.15), as well as increases in HIA (right: +1.56°, left: +1.39°) and MPTA (right: +1.11°, left: +0.89°), whereas the CG showed minimal changes. For balance outcomes, significant interactions were identified in selected static and dynamic balance measures (P<0.05), with post hoc analyses indicating improvements primarily in the EG. A 12-week neuromuscular exercise program may be beneficial for improving alignment-related measures, reducing pain, and enhancing selected balance outcomes in individuals with genu varum.