The Effect of Prolonged Posture on the Pelvis and Lower Extremities Alignment: A Study of Video Game Users

Abstract

Background: The sedentary lifestyle resulting from long-term video game playing has presented the musculoskeletal system of the young generation with serious biomechanical challenges and injuries. Despite the predominant focus of previous studies on upper limb and cervicothoracic spine abnormalities, the present study was designed and implemented with the aim of comparing the frequency and severity of lower limb postural and musculoskeletal abnormalities between adolescent gamers and non-gamers. Methods: This observational and cross-sectional comparative study was conducted on 40 participants (12 to 20 years old) in two independent groups of 20 each including gamers and non-gamers. Assessments included measurement of lumbar lordosis, assessment of pelvic tilt, severity of genu valgum, navicular drop, and functional tests to measure lower limb muscle shortening (Thomas test, active knee extension, and lunge). Data were analyzed using two-way analysis of variance. Findings: Compared to the non-gamers, the gamer group showed significantly greater values in lumbar lordosis, anterior pelvic tilt, iliopsoas muscle shortening, and genu valgum severity (P < 0.001). However, no significant differences were found in more distal variables such as navicular drop, ankle dorsiflexion range of motion, rectus femoris shortening, and hamstring flexibility between the two groups. The analyses showed that gender had no significant main or interaction effect on these abnormalities. Conclusion: The results showed that prolonged sitting in gamers is associated with postural changes in the flexors, while it is less associated with more distal structures in the short term. Specialists can use these findings to design ergonomic programs and pelvic stabilization exercises for the rehabilitation of this group. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.