Effects of Pilates and Neuromuscular Exercises on Postural Control in Dynamic Knee Valgus

Overview

This randomized controlled trial aims to investigate the effects of neuromuscular and Pilates exercise programs compared with a control group in young adults with dynamic knee valgus (DKV). Thirty-six participants were randomly assigned to neuromuscular, Pilates, or control groups. The intervention groups completed a supervised exercise program three times per week for six weeks (18 sessions). The primary outcome is the frontal plane projection angle (FPPA) during single-leg tasks. Secondary outcomes include muscle strength, balance, and vertical jump performance.

This prospective, single-blind randomized controlled trial was designed to evaluate the comparative effects of Pilates and neuromuscular exercise training on lower extremity alignment and postural control in young adults with dynamic knee valgus (DKV). Ethical approval was obtained from the Istanbul Atlas University Non-Interventional Scientific Research Ethics Committee (Approval No: E-22686390-050.99-41964, 03/05/2024). A total of 45 participants aged 18-24 years, all right-leg dominant, were initially enrolled and randomized into three groups: Pilates, neuromuscular exercise, and control (15 in each group). Randomization was performed using computerized allocation. Due to dropouts, 36 participants (12 per group) completed the study between June and August 2024. The interventions consisted of a 6-week supervised program (18 sessions, 3 times per week). Both Pilates and neuromuscular protocols were progressive in intensity, incorporating resistance bands, core stabilization, and functional balance exercises. The control group did not receive any intervention but underwent the same baseline and post-intervention assessments. The primary outcome was the frontal plane projection angle (FPPA) during single-leg squat and single-leg drop jump tasks, measured using 2D video analysis. The secondary outcomes included: Isometric strength of the gluteus medius and rectus femoris measured with a handheld dynamometer, Balance performance assessed separately by the Biodex Postural Stability Test (overall, anterior-posterior, and medial-lateral stability indices) and the Limits of Stability Test, Functional performance assessed by the OptoJump system, including vertical jump height, vertical jump power, and reactive strength index. All assessments were conducted at baseline and after 6 weeks by the same physiotherapist to ensure intra-rater reliability.