The Effectiveness of Video-Based Game Exercise Therapy Applications in Pes Planus Rehabilitation: A Randomized Controlled Trial.

Background: This study aimed to evaluate the effectiveness of serious game, exergame, and structured exercises in pes planus rehabilitation. Methods: Sixty-nine individuals with pes planus were included in this study. Individuals were randomly divided into three groups: a structured exercise group (SEG), an exergame group (EGG), and a serious game group (SGG). The average age of the participants was 21.02, and their body mass index was 21.91 kg/m². Interventions were performed three times a week for 6 weeks. Navicular drop, plantar pressure analysis, femoral anteversion, balance, and muscle strength were evaluated pre- and post-treatment. A small effect size of 0.2 was applied for navicular drop, balance, and plantar pressure analysis, and a medium effect size of 0.5 for femoral anteversion and muscle strength analysis. Results: Navicular drop and muscle strength improved significantly in all groups (P < 0.05). The strength of the inverter, plantar flexor, and dorsiflexor muscles was found to be significantly greater in the SGG than in the other groups (P < 0.05). Balance showed significant improvement only in EGG and SGG (P < 0.05). The decrease in medial plantar pressure was found to be significant in both feet in SGG and only in the left foot in the SEG (P < 0.05). The subtalar angle improved significantly in both feet in the SGG and only in the right foot in the SEG (P < 0.05). No significant change was observed in the EGG (P > 0.05). Femoral anteversion did not change in any of the three groups (P > 0.05). Conclusion: Individuals with pes planus obtained more improvements in plantar pressure analysis, subtalar angle, and muscle strength after serious games rather than structured exercises and exergame. It was considered that serious game exercise programs would be used in pes planus.