Sport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622The Effect of Eight Weeks Reactive Neuromuscular Training on Balance and Genu Valgum of 8–12-Year-Old StudentsThe Effect of Eight Weeks Reactive Neuromuscular Training on Balance and Genu Valgum of 8–12-Year-Old Students1732451110.22089/smj.2025.16715.1746FAFaezehKarimzadeh JazyMaster of Corrective Exercise and Sport Injuries, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran0009-0004-7514-0662NaderRahnamaFull Professor, Department of Sport Injuries, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran0000-0002-0443-4303Journal Article20240619<strong><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The knee joint, one </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">of the most complex and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">essential</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> joints </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">in</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the lower limb</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> is </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">particularly susceptible to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">postural abnormalities</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Genu Valgum</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> being among the most prevalent. Individuals</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with Genu Valgum</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> exhibit knees positioned</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> close together, external </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">tibial </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">rotation</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> and internal </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">femoral </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">rotation. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">These biomechanical alterations may contribute to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> impairments. Given that specific</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> training </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">interventions may</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> improve </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">both </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">the deformity and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">functional </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">performance, this </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">study aimed</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">evaluate</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the effect of reactive neuromuscular training </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(RNT) </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">on the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">degree</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> of Genu Valgum </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">as well as</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> static and dynamic balance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">in</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> female students.</span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> applied quasi-experimental study </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was conducted as part of </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">a </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">master’s</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> thesis in Corrective Exercise and Sport Injuries. The </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">study</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> population </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">included</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> female students aged 8</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">–</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">12 years from schools </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">located</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in District 6 of Isfahan. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Based on</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> statistical </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">power considerations and G*Power software recommendations</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, a </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">sample</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> of 30 individuals </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">diagnosed</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Genu Valgum was</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> selected </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">and randomly allocated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> into two groups of 15</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">experimental </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">and control</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Inclusion</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> criteria included</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: age</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 8</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">–</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">12 years, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">absence of lower limb injuries in the preceding year,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> no </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">ongoing pain or </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">history of </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">surgery</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the lower </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">limbs, equal</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> leg </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">lengths</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, voluntary participation </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">informed consent, and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">no use of</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> orthotic insoles. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Exclusion</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> criteria were </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">withdrawal from the study, missing more than three consecutive or five nonconsecutive training sessions, and any injury precluding protocol completion or</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> participation in post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">testing. All participants provided </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">informed consent</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> before</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the study.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anthropometric data, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">age, height, weight, actual </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">leg lengths</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">inter-malleolar</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> distance</span><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">were</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> measured</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. Height and leg length were measured using a</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> wall-mounted tape </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">accurate to 1 cm; weight was recorded with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">a Breuer digital scale</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">; the inter-malleolar</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> distance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was assessed with a caliper</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Dominant</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> foot</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> was determined by two </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">methods</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: (1) instructing the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">participant to kick a soccer ball </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">toward</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> a one-meter-wide goal </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">at</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 10 meters </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">distance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with moderate </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">power and maximal</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> accuracy</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">kicking </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">foot </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">classified as dominant; (2) self-report confirmation.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Dynamic balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> was </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">assessed using the Star Excursion Balance Test, whereas</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> static balance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was evaluated via the Stork Balance Test. Following</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> pre-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">testing</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, the experimental group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">underwent</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> an eight-week selective </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">reactive neuromuscular </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">training program, while the control </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">group received no intervention. Post-testing </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">replicated </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">baseline assessments</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><strong><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span></strong><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results<br></span></strong><strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Static balance</span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: Repeated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> measures ANOVA </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">revealed significant</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> improvement in </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">static balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">intervention for</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> both groups</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the experimental group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">demonstrating significantly greater gains than controls (p < 0.05).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Dynamic balance</span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: Analysis of Star Excursion Balance Test</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> results </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">indicated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">improvements after eight weeks of RNT</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the anterior, anterolateral, and posterior directions</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> compared to control (p < 0.05). No</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">changes were</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> found in anteromedial, posteromedial, posterolateral, lateral, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">or</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> medial directions</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">.</span><br><strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Genu Valgum: </span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Cross-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">knee </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">distance analyses showed an increase</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the control group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">from</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> pre-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> to post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">test</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, whereas</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the experimental group</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> exhibited a decrease post-intervention. Time and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">interaction effects were </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">statistically</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(p <</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 0.001</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">), while</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">between-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">group effect </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was non-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">significant (p</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> > </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">0.05).</span><br><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><strong><span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Table1- Mean and standard deviation of research variables by groups</span></strong><br><br><br><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Variable</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Groups</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Pre-test</span></strong><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mean and standard deviation</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Post-test mean and standard deviation</span></strong><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Static balance (Stork test)</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Sec)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">33/0 ± 14/4</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">45/9 ± 15/3</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">36/8 ± 17/2</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">73/5 ± 27/2</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">96/8± 12/8</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">100/2 ± 12/6</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">89/0 ± 12/1</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">103/0 ± 9/5</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior medial Dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">95/4 ± 16/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">98/0 ± 17/4</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">86/5 ± 13/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">90/8 ± 14/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior external Dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">92/6 ± 13/7</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">95/7 ± 12/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/9 ± 11/0</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">104/9 ± 11/2</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/0 ± 12/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/9 ± 11/3</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">73/4 ± 8/7</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">87/6 ± 9/1</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior medial dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/0 ± 11/1</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/3 ± 11/5</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">79/2 ± 15/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">84/2 ± 16/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior external dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">86/7 ± 15/3</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">187/8 ± 10/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">78/6 ± 13/8</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">87/4 ± 10/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span>Medial dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">78/4 ± 14/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/5 ± 16/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">75/5 ± 20/4</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">76/2 ± 19/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">External dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/0 ± 24/0</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">91/2 ± 13/9</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">74/2 ± 18/3</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">85/2 ± 9/0</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Amount of Genu Valgum</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Inner ankle distance)</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span>(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">6/9 ± 1/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">7/1 ± 1/6</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">8/2 ± 1/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">6/5 ± 1/2</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conclusion</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study evaluated the effects of an eight-week reactive neuromuscular training on Genu Valgum and balance performance. RNT exercises, such as linear lunges with Thera Band elastic resistance, impose controlled perturbations that enhance stability and static balance. Improved strength across the lumbar-pelvic-femoral kinetic chain and enhanced proprioception contributed to superior test performance. These findings concur with Kim et al. (2012), who documented balance improvements following eight weeks of RNT (8), and Mirzaei et al. (2020), who reported improved dynamic balance in women with dynamic knee valgus after a single RNT session (4).</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">RNT promotes correct movement patterns via active error detection and feedback, facilitating dynamic muscular stability and limiting abnormal joint motions. Elastic resistance in these exercises is utilized not for strength gains per se but to provide tension cues emphasizing proper body positioning and control during movement (33, 34, 22). Such interventions have been employed successfully to restore functional stability in injured athletes (22).</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Melinda Pittman (2013) studied the impact of RNT on knee biomechanics in 29 women, demonstrating increased landing stability and reduced dynamic valgus after eight weeks of RNT. She concluded that pre-sport specific RNT improves performance and diminishes anterior cruciate ligament injury risk in individuals exhibiting valgus at landing (35). The present results align closely with Pittman’s study, as the training targeted valgus control in frontal and sagittal planes.</span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Article Message</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Based on this study’s findings, reactive neuromuscular exercises effectively reduce Genu Valgum and improve balance. It is recommended these exercises be integrated into corrective exercise programs for students with musculoskeletal dysfunctions.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Ethical Considerations</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study was conducted under the supervision of the Ethics Committee of the University of Isfahan, with approval code IR.UI.REC.1402.093 (</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">https://ethics.research.ac.ir/EthicsProposalView.php?&code=IR.UI.REC.1402.093</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Authors’ Contributions</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conceptualization, data collection, data analysis, and manuscript writing were performed by Faezeh Karimzadeh. Review and editing were conducted by Dr. Nader Rahnama, who also served as project manager and responsible author. Literature review was contributed by Karimzadeh, Rahnama, and Dr. M. Namazizadeh.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conflict of Interest</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors declare no conflicts of interest.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Acknowledgments</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This research derives from Faezeh Karimzadeh’s master’s thesis, supervised by Dr. Nader Rahnama. The authors express sincere gratitude to all who supported and participated in this study.</span><br><strong><span dir="RTL" lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong><strong><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The knee joint, one </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">of the most complex and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">essential</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> joints </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">in</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the lower limb</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> is </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">particularly susceptible to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">postural abnormalities</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> Genu Valgum</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> being among the most prevalent. Individuals</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with Genu Valgum</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> exhibit knees positioned</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> close together, external </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">tibial </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">rotation</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> and internal </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">femoral </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">rotation. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">These biomechanical alterations may contribute to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> impairments. Given that specific</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> training </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">interventions may</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> improve </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">both </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">the deformity and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">functional </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">performance, this </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">study aimed</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> to </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">evaluate</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the effect of reactive neuromuscular training </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(RNT) </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">on the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">degree</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> of Genu Valgum </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">as well as</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> static and dynamic balance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">in</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> female students.</span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Methods</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> applied quasi-experimental study </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was conducted as part of </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">a </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">master’s</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> thesis in Corrective Exercise and Sport Injuries. The </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">study</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> population </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">included</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> female students aged 8</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">–</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">12 years from schools </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">located</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in District 6 of Isfahan. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Based on</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> statistical </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">power considerations and G*Power software recommendations</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, a </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">sample</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> of 30 individuals </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">diagnosed</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Genu Valgum was</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> selected </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">and randomly allocated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> into two groups of 15</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">experimental </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">and control</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Inclusion</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> criteria included</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: age</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 8</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">–</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">12 years, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">absence of lower limb injuries in the preceding year,</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> no </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">ongoing pain or </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">history of </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">surgery</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the lower </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">limbs, equal</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> leg </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">lengths</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, voluntary participation </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">informed consent, and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">no use of</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> orthotic insoles. </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Exclusion</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> criteria were </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">withdrawal from the study, missing more than three consecutive or five nonconsecutive training sessions, and any injury precluding protocol completion or</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> participation in post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">testing. All participants provided </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">informed consent</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> before</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the study.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anthropometric data, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">age, height, weight, actual </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">leg lengths</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">inter-malleolar</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> distance</span><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">were</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> measured</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. Height and leg length were measured using a</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> wall-mounted tape </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">accurate to 1 cm; weight was recorded with </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">a Breuer digital scale</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">; the inter-malleolar</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> distance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was assessed with a caliper</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Dominant</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> foot</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> was determined by two </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">methods</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: (1) instructing the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">participant to kick a soccer ball </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">toward</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> a one-meter-wide goal </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">at</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 10 meters </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">distance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> with moderate </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">power and maximal</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> accuracy</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">kicking </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">foot </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">classified as dominant; (2) self-report confirmation.</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Dynamic balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> was </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">assessed using the Star Excursion Balance Test, whereas</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> static balance </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was evaluated via the Stork Balance Test. Following</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> pre-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">testing</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">, the experimental group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">underwent</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> an eight-week selective </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">reactive neuromuscular </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">training program, while the control </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">group received no intervention. Post-testing </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">replicated </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">baseline assessments</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">.</span><br><strong><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span></strong><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Results<br></span></strong><strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Static balance</span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: Repeated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> measures ANOVA </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">revealed significant</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> improvement in </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">static balance</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">intervention for</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> both groups</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, with</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the experimental group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">demonstrating significantly greater gains than controls (p < 0.05).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Dynamic balance</span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">: Analysis of Star Excursion Balance Test</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> results </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">indicated</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">improvements after eight weeks of RNT</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the anterior, anterolateral, and posterior directions</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> compared to control (p < 0.05). No</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">changes were</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> found in anteromedial, posteromedial, posterolateral, lateral, </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">or</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> medial directions</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">.</span><br><strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Genu Valgum: </span></strong><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Cross-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">knee </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">distance analyses showed an increase</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> in the control group </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">from</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> pre-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> to post-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">test</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">, whereas</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the experimental group</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> exhibited a decrease post-intervention. Time and </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">interaction effects were </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">statistically</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> significant </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(p <</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> 0.001</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">), while</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> the </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">between-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">group effect </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">was non-</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">significant (p</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> > </span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">0.05).</span><br><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><strong><span dir="LTR" style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Table1- Mean and standard deviation of research variables by groups</span></strong><br><br><br><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Variable</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Groups</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Pre-test</span></strong><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mean and standard deviation</span></strong><br><br><br><strong><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Post-test mean and standard deviation</span></strong><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Static balance (Stork test)</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Sec)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">33/0 ± 14/4</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">45/9 ± 15/3</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">36/8 ± 17/2</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">73/5 ± 27/2</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">96/8± 12/8</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">100/2 ± 12/6</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">89/0 ± 12/1</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">103/0 ± 9/5</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior medial Dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">95/4 ± 16/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">98/0 ± 17/4</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">86/5 ± 13/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">90/8 ± 14/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Anterior external Dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">92/6 ± 13/7</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">95/7 ± 12/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/9 ± 11/0</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">104/9 ± 11/2</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/0 ± 12/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/9 ± 11/3</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">73/4 ± 8/7</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">87/6 ± 9/1</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior medial dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/0 ± 11/1</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/3 ± 11/5</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">79/2 ± 15/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">84/2 ± 16/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Posterior external dynamic balance (Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">86/7 ± 15/3</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">187/8 ± 10/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">78/6 ± 13/8</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">87/4 ± 10/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span>Medial dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">78/4 ± 14/6</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">81/5 ± 16/7</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">75/5 ± 20/4</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">76/2 ± 19/8</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">External dynamic balance</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">83/0 ± 24/0</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">91/2 ± 13/9</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">74/2 ± 18/3</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">85/2 ± 9/0</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Amount of Genu Valgum</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">(Inner ankle distance)</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><span style="mso-spacerun: yes;"> </span>(Cm)</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Control</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">6/9 ± 1/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">7/1 ± 1/6</span><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Experimental</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">8/2 ± 1/5</span><br><br><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">6/5 ± 1/2</span><br><span dir="LTR" style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><br><br><br><br><br><span dir="LTR" style="font-size: 9.0pt; line-height: 107%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"> </span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conclusion</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study evaluated the effects of an eight-week reactive neuromuscular training on Genu Valgum and balance performance. RNT exercises, such as linear lunges with Thera Band elastic resistance, impose controlled perturbations that enhance stability and static balance. Improved strength across the lumbar-pelvic-femoral kinetic chain and enhanced proprioception contributed to superior test performance. These findings concur with Kim et al. (2012), who documented balance improvements following eight weeks of RNT (8), and Mirzaei et al. (2020), who reported improved dynamic balance in women with dynamic knee valgus after a single RNT session (4).</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">RNT promotes correct movement patterns via active error detection and feedback, facilitating dynamic muscular stability and limiting abnormal joint motions. Elastic resistance in these exercises is utilized not for strength gains per se but to provide tension cues emphasizing proper body positioning and control during movement (33, 34, 22). Such interventions have been employed successfully to restore functional stability in injured athletes (22).</span><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Melinda Pittman (2013) studied the impact of RNT on knee biomechanics in 29 women, demonstrating increased landing stability and reduced dynamic valgus after eight weeks of RNT. She concluded that pre-sport specific RNT improves performance and diminishes anterior cruciate ligament injury risk in individuals exhibiting valgus at landing (35). The present results align closely with Pittman’s study, as the training targeted valgus control in frontal and sagittal planes.</span><br><strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Article Message</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Based on this study’s findings, reactive neuromuscular exercises effectively reduce Genu Valgum and improve balance. It is recommended these exercises be integrated into corrective exercise programs for students with musculoskeletal dysfunctions.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Ethical Considerations</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This study was conducted under the supervision of the Ethics Committee of the University of Isfahan, with approval code IR.UI.REC.1402.093 (</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">https://ethics.research.ac.ir/EthicsProposalView.php?&code=IR.UI.REC.1402.093</span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Authors’ Contributions</span></strong><br><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conceptualization, data collection, data analysis, and manuscript writing were performed by Faezeh Karimzadeh. Review and editing were conducted by Dr. Nader Rahnama, who also served as project manager and responsible author. Literature review was contributed by Karimzadeh, Rahnama, and Dr. M. Namazizadeh.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Conflict of Interest</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">The authors declare no conflicts of interest.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">Acknowledgments</span></strong><span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"><br></span><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">This research derives from Faezeh Karimzadeh’s master’s thesis, supervised by Dr. Nader Rahnama. The authors express sincere gratitude to all who supported and participated in this study.</span><br><strong><span dir="RTL" lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>https://smj.ssrc.ac.ir/article_4511_475fbefa9ebfba9233364533aafd02a3.pdfSport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622Investigation and Analysis of Single-Parameter and Multi-Parameter Criteria of Head Injury in Collision SportsInvestigation and Analysis of Single-Parameter and Multi-Parameter Criteria of Head Injury in Collision Sports3348438410.22089/smj.2024.16683.1745FANedaBoroushakSport Science Research Institute of IRAN (SSRII), Sports Biomechanics Department, Tehran, Iran0000-0003-3953-722XHasanKhoshnoodiDepartment of Mechanical Engineering, Shoushtar Branch, Islamic Azad University, Shoushtar, Iran0000-0001-5035-8113Journal Article20240427<strong>Background and Purpose</strong><br>The risk of brain injuries, especially in competitive and championship sports, is an undeniable fact. In order to reduce the risk of brain injury, much research has been conducted on the biomechanics of brain injury, in which various injury assessment criteria have been proposed for different types of head injuries.<br>In contact sports, most head injury criteria are evaluated based on the kinematic response of the head to impact. In impact sports such as taekwondo, boxing and other impact sports, when a blow is made to the head, both linear acceleration and rotational acceleration are produced simultaneously in the head, and this can possibly change the threshold of head injury compared to the case where each of these criteria is considered separately. As mentioned earlier, this issue has not been considered in previous studies. Therefore, this study intends to examine combined criteria in addition to examining injury from the perspective of single-parameter criteria such as linear acceleration and rotational acceleration. The purpose of this study is to investigate and analyze the single-parameter criteria of linear acceleration and rotational acceleration and the GAMBIT multi<span dir="RTL" lang="FA">-</span>parameter criterion in head injury in impact sports.<br><strong> </strong><br><strong>Methods</strong><br>In this study, in order to evaluate GAMBIT in contact sports, first, information from previous studies (linear acceleration and rotational acceleration) in the field of head injuries in boxing, taekwondo, wrestling, judo and MMA was collected. For this purpose, there was a need to first model a blow to the head in martial arts, so modeling from previous research was used.<br>After collecting the information, those parameters that were not included in previous studies were simulated and calculated using Adams software.<br>With an appropriate and reliable model, it is possible to examine and complete the results of other research in this field. In order to ensure the accuracy and precision of the modeling of this study, a direct punch in boxing and a rotational leg kick in taekwondo were simulated in accordance with previous studies and their results were compared with each other. After comparing the results of previous experiments with the simulation method in this study and ensuring its accuracy, this model was used to continue the work and simulate the parameters required in this study. After collecting and obtaining the accelerations from previous studies, the GAMBIT criterion was also obtained in the MATLAB program. Finally, the linear acceleration, rotational acceleration, and GAMBIT criteria and their injury threshold values in impact sports were examined and analyzed.<br> <br><strong>Results</strong><br>The results of the modeling validation of the present study, with an error range of 2.9% to 4.8%, indicate the validity of the modeling of this study, which can be relied on for simulation. Since each study was conducted with a different method and unique materials and computational techniques were used, it is obvious that there is a percentage difference between different methods and studies.<br>According to the results of this study, the most research conducted in the field of head impact in martial arts is in boxing, taekwondo, judo, and MMA, respectively. The results also showed that the rotational acceleration produced in the head has its highest value in taekwondo (5251.78 rad/s2), MMA (5172.70 rad/s2), boxing (4951.53 rad/s2), and judo (1889.66 rad/s2), respectively. The rotational acceleration generated in different martial arts with the injury thresholds given in the references was compared and the occurrence of injury in these cases was examined.<br>A review of previous research showed that the highest linear acceleration produced in the head due to impact in martial arts is in taekwondo (142/42 g). After that, boxing (86/66 g), judo (61/35 g), and MMA (50/55 g) showed the highest value, respectively. By simultaneously considering linear and rotational accelerations in the GAMBIT equation, a new criterion for the threshold of brain injury in each sport was obtained. In the study, the highest GAMBIT values were determined for taekwondo (0.57), boxing (0.38), MMA (0.27), and judo (0.25), respectively. And the damage threshold was also plotted from the point of view of the GAMBIT composite criterion.<br> <br><strong>Conclusion</strong><br>In the study of the mechanism of head injury, it was shown that two types of impact and non-impact loading can be distinguished, each of which leads to different responses in the head. In impact loading, the impact force is considered the cause of the injury. In non-impact situations, the head is loaded only as a result of the force resulting from inertia, i.e. acceleration. This acceleration can be linear or rotational, with linear acceleration leading to local damage and rotational acceleration leading to diffuse and extensive brain damage.<br>In comparing the gambit achieved in each discipline with its tolerance criterion, the red line shows the gambit injury threshold, according to which the gambits achieved in combat sports are lower than the head injury threshold. In general, the closer the gambit value is to unity, the greater the risk of injury to the athlete's head. In general, in the comparison of the four disciplines, the amount of gambit in taekwondo was higher but it was not exposed to the threshold of head injury, which is probably due to the fact that the time parameter was not taken into account in the calculations and the criteria and threshold of injury. However, in determining the threshold of injury by a criterion such as HIC, time is also taken into account and calculated, and this duration of contact in the impact is very important from the perspective of momentum and impact severity.<br>The comparisons made with the thresholds of injury have several points. First, the threshold of injury in the study using single-parameter criteria is much lower than the threshold of injury in multi-parameter criteria, and this could be due to the occurrence of injury through a secondary parameter during the determination of the threshold of injury by the main parameter that was outside the calculations of the researchers. Another point in observing the difference in response to injury in the study using different parameters could be different definitions of the type and nature of head injury, the use of different measuring devices for these injuries, or errors in recording this information, which indicates the need to review and conduct more detailed medical and clinical studies in recording these criteria and thresholds. Because the accuracy in defining these thresholds, along with strict considerations, can change the boundaries of the definition of injury and, consequently, sports standards, performance techniques in contact sports, and materials used in protective sports clothing. Finally, it can be suggested that a more comprehensive and complete multi-parameter criterion be considered and injury thresholds be determined according to it.<br><strong> </strong><br><strong>Article</strong><strong> </strong><strong>Message</strong><br>The results of this study showed that considering each of the linear and rotational accelerations alone, in the assessment of head injury in martial arts, the rotational acceleration is higher than the threshold for head injury, which was higher in taekwondo. However, considering the Gambit criterion in examining the threshold for head injury, it was found that blows to the head in martial arts do not expose athletes to head injury. To obtain more information about the Gambit criterion, more research is needed, such as laboratory studies and the use of subjects, which is suggested to be considered by researchers in the future.<br><strong>Ethical Considerations</strong><br>Since no subjects were used in this study and the data and results were based on previous studies, computer simulations, and programming outputs, there was no need to obtain a code of ethics from the competent authorities.<br><strong>Authors’ Contributions </strong><br>Conceptualization: Boroushak and Khoshnoodi<br>Data Collection: Khoshnoodi and Boroushak<br>Data Analysis: Khoshnoodi and Boroushak<br>Manuscript Writing: Boroushak and Khoshnoodi<br>Review and Editing: Khoshnoodi<br>Responsible for funding: Boroushak<br>Literature Review: Boroushak and Khoshnoodi<br>Project Manager: Boroushak<br>Any other contributions: Computer simulation and programming were performed by Dr. Khoshnoodi.<br><strong>Conflict of Interest</strong><br>No conflict of Interest.<br><strong>Acknowledgments</strong><br>This article is an extract from the research project of Dr. Neda Broshak at the Institute of Physical Education and Sport Sciences of Iran. The authors of this article are grateful for the material and moral support of the Institute.<strong>Background and Purpose</strong><br>The risk of brain injuries, especially in competitive and championship sports, is an undeniable fact. In order to reduce the risk of brain injury, much research has been conducted on the biomechanics of brain injury, in which various injury assessment criteria have been proposed for different types of head injuries.<br>In contact sports, most head injury criteria are evaluated based on the kinematic response of the head to impact. In impact sports such as taekwondo, boxing and other impact sports, when a blow is made to the head, both linear acceleration and rotational acceleration are produced simultaneously in the head, and this can possibly change the threshold of head injury compared to the case where each of these criteria is considered separately. As mentioned earlier, this issue has not been considered in previous studies. Therefore, this study intends to examine combined criteria in addition to examining injury from the perspective of single-parameter criteria such as linear acceleration and rotational acceleration. The purpose of this study is to investigate and analyze the single-parameter criteria of linear acceleration and rotational acceleration and the GAMBIT multi<span dir="RTL" lang="FA">-</span>parameter criterion in head injury in impact sports.<br><strong> </strong><br><strong>Methods</strong><br>In this study, in order to evaluate GAMBIT in contact sports, first, information from previous studies (linear acceleration and rotational acceleration) in the field of head injuries in boxing, taekwondo, wrestling, judo and MMA was collected. For this purpose, there was a need to first model a blow to the head in martial arts, so modeling from previous research was used.<br>After collecting the information, those parameters that were not included in previous studies were simulated and calculated using Adams software.<br>With an appropriate and reliable model, it is possible to examine and complete the results of other research in this field. In order to ensure the accuracy and precision of the modeling of this study, a direct punch in boxing and a rotational leg kick in taekwondo were simulated in accordance with previous studies and their results were compared with each other. After comparing the results of previous experiments with the simulation method in this study and ensuring its accuracy, this model was used to continue the work and simulate the parameters required in this study. After collecting and obtaining the accelerations from previous studies, the GAMBIT criterion was also obtained in the MATLAB program. Finally, the linear acceleration, rotational acceleration, and GAMBIT criteria and their injury threshold values in impact sports were examined and analyzed.<br> <br><strong>Results</strong><br>The results of the modeling validation of the present study, with an error range of 2.9% to 4.8%, indicate the validity of the modeling of this study, which can be relied on for simulation. Since each study was conducted with a different method and unique materials and computational techniques were used, it is obvious that there is a percentage difference between different methods and studies.<br>According to the results of this study, the most research conducted in the field of head impact in martial arts is in boxing, taekwondo, judo, and MMA, respectively. The results also showed that the rotational acceleration produced in the head has its highest value in taekwondo (5251.78 rad/s2), MMA (5172.70 rad/s2), boxing (4951.53 rad/s2), and judo (1889.66 rad/s2), respectively. The rotational acceleration generated in different martial arts with the injury thresholds given in the references was compared and the occurrence of injury in these cases was examined.<br>A review of previous research showed that the highest linear acceleration produced in the head due to impact in martial arts is in taekwondo (142/42 g). After that, boxing (86/66 g), judo (61/35 g), and MMA (50/55 g) showed the highest value, respectively. By simultaneously considering linear and rotational accelerations in the GAMBIT equation, a new criterion for the threshold of brain injury in each sport was obtained. In the study, the highest GAMBIT values were determined for taekwondo (0.57), boxing (0.38), MMA (0.27), and judo (0.25), respectively. And the damage threshold was also plotted from the point of view of the GAMBIT composite criterion.<br> <br><strong>Conclusion</strong><br>In the study of the mechanism of head injury, it was shown that two types of impact and non-impact loading can be distinguished, each of which leads to different responses in the head. In impact loading, the impact force is considered the cause of the injury. In non-impact situations, the head is loaded only as a result of the force resulting from inertia, i.e. acceleration. This acceleration can be linear or rotational, with linear acceleration leading to local damage and rotational acceleration leading to diffuse and extensive brain damage.<br>In comparing the gambit achieved in each discipline with its tolerance criterion, the red line shows the gambit injury threshold, according to which the gambits achieved in combat sports are lower than the head injury threshold. In general, the closer the gambit value is to unity, the greater the risk of injury to the athlete's head. In general, in the comparison of the four disciplines, the amount of gambit in taekwondo was higher but it was not exposed to the threshold of head injury, which is probably due to the fact that the time parameter was not taken into account in the calculations and the criteria and threshold of injury. However, in determining the threshold of injury by a criterion such as HIC, time is also taken into account and calculated, and this duration of contact in the impact is very important from the perspective of momentum and impact severity.<br>The comparisons made with the thresholds of injury have several points. First, the threshold of injury in the study using single-parameter criteria is much lower than the threshold of injury in multi-parameter criteria, and this could be due to the occurrence of injury through a secondary parameter during the determination of the threshold of injury by the main parameter that was outside the calculations of the researchers. Another point in observing the difference in response to injury in the study using different parameters could be different definitions of the type and nature of head injury, the use of different measuring devices for these injuries, or errors in recording this information, which indicates the need to review and conduct more detailed medical and clinical studies in recording these criteria and thresholds. Because the accuracy in defining these thresholds, along with strict considerations, can change the boundaries of the definition of injury and, consequently, sports standards, performance techniques in contact sports, and materials used in protective sports clothing. Finally, it can be suggested that a more comprehensive and complete multi-parameter criterion be considered and injury thresholds be determined according to it.<br><strong> </strong><br><strong>Article</strong><strong> </strong><strong>Message</strong><br>The results of this study showed that considering each of the linear and rotational accelerations alone, in the assessment of head injury in martial arts, the rotational acceleration is higher than the threshold for head injury, which was higher in taekwondo. However, considering the Gambit criterion in examining the threshold for head injury, it was found that blows to the head in martial arts do not expose athletes to head injury. To obtain more information about the Gambit criterion, more research is needed, such as laboratory studies and the use of subjects, which is suggested to be considered by researchers in the future.<br><strong>Ethical Considerations</strong><br>Since no subjects were used in this study and the data and results were based on previous studies, computer simulations, and programming outputs, there was no need to obtain a code of ethics from the competent authorities.<br><strong>Authors’ Contributions </strong><br>Conceptualization: Boroushak and Khoshnoodi<br>Data Collection: Khoshnoodi and Boroushak<br>Data Analysis: Khoshnoodi and Boroushak<br>Manuscript Writing: Boroushak and Khoshnoodi<br>Review and Editing: Khoshnoodi<br>Responsible for funding: Boroushak<br>Literature Review: Boroushak and Khoshnoodi<br>Project Manager: Boroushak<br>Any other contributions: Computer simulation and programming were performed by Dr. Khoshnoodi.<br><strong>Conflict of Interest</strong><br>No conflict of Interest.<br><strong>Acknowledgments</strong><br>This article is an extract from the research project of Dr. Neda Broshak at the Institute of Physical Education and Sport Sciences of Iran. The authors of this article are grateful for the material and moral support of the Institute.https://smj.ssrc.ac.ir/article_4384_12e59a33dea1bf0630f46edfe13d6ea2.pdfSport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622The Relationship Between Sleep Disorder with Landing Kinematic, Balance and Proprioception Lower Limb in Men with History of ACLR and Dynamic Knee ValgusThe Relationship Between Sleep Disorder with Landing Kinematic, Balance and Proprioception Lower Limb in Men with History of ACLR and Dynamic Knee Valgus49128454210.22089/smj.2025.17104.1768FAMostafaJalili BafroePh.D. student, Faculty of Physical education & sport sciences, University of Tehran, Tehran, IranMohammadrezaSeyediAssistant professor, Sports Medicine department, Sport Sciences Research Institute, Tehran, Iran0000-0002-5551-4610Seyed HosseinMirkarimpourAssistant professor, Shomal University, Amol, Iran0000-0001-8272-4309Journal Article20240818<strong style="mso-bidi-font-weight: normal;">Background and Purpose</strong><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Sleep, a vital biological need, occupies about 35% of human life and plays a crucial role in maintaining optimal physical, cognitive, and psychological health. For athletes, adequate sleep is essential as it enhances performance, promotes effective recovery, strengthens immune function, and facilitates learning and memory consolidation, while simultaneously reducing fatigue, mental stress, and risk of injury. However, athletes frequently face sleep disturbances due to factors such as high training loads, competition stress, frequent travel across time zones, and irregular daily schedules. These conditions often necessitate athletes to obtain 9–10 hours of sleep nightly to sustain optimal functioning. Sleep disorders including insomnia, sleep apnea, or circadian rhythm disruptions affect 30–45% of the global population and negatively influence neurological, endocrine, and motor functions, leading to impairments in balance, decision-making abilities, reaction times, and muscle strength.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study focuses specifically on poor sleep quality as a potential and modifiable risk factor for secondary anterior cruciate ligament (ACL) injuries in athletes. ACL injuries significantly compromise knee stability, proprioception, and lower-limb movement kinematics, which cumulatively increase the risk of reinjury during dynamic sports activities. Additionally, factors such as gender, age, incomplete or inadequate rehabilitation, and persistent fatigue can further elevate these risks. Post-ACL reconstruction, altered lower-limb kinematics characterized by increased knee valgus and reduced flexion angles might predispose athletes to secondary injuries. Given the severe physical, psychological, and economic consequences of failed ACL repairs, identifying modifiable risk factors such as sleep quality and disturbances is critically important. This research investigates the extent to which sleep disturbances exacerbate deficits in kinematics, balance, and proprioception, thereby contributing to the risk of secondary ACL injuries. The findings are expected to provide valuable insights for athletes, coaches, and clinicians and inform the development of targeted preventive strategies to reduce reinjury incidence and improve long-term athlete health and performance.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Materials and Methods</span></strong><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study employed a descriptive, applied, and within-group design to investigate the relationship between sleep quality and functional outcomes including kinematics, balance, and proprioception in male athletes with a history of anterior cruciate ligament reconstruction (ACLR). The target population consisted of men residing in Tehran who had undergone ACLR at least six months prior, experienced non-contact injury mechanisms, and consistently played football at least twice weekly. Using G*Power software with a power of 0.80 and an effect size of 0.60, a calculated sample size of 44 participants was determined and selected purposively based on strict inclusion criteria to ensure homogeneity.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Inclusion Criteria consisted of males aged between 25 and 35 years, with a normal BMI range of 18–25 kg/m², who had received hamstring autograft ACLR, exhibited positive dynamic knee valgus during single-leg squat assessments, did not use sedatives or psychiatric medications in the preceding three months, had engaged in a minimum of 50 hours of sports activity annually before ACLR, completed standardized post-ACLR rehabilitation protocols, and had no history of prior lower-limb surgeries other than ACLR, nor any multi-ligament or osteochondral injuries.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Exclusion criteria included any discomfort, pain, or injury occurring during testing sessions or inability to complete the full assessment protocols. Participants were actively recruited through collaboration with physiotherapy clinics and knee surgeons in Tehran, ensuring access to relevant patient populations. This carefully controlled sample allows for focused examination of how sleep quality correlates with critical functional parameters relevant to athletic performance and reinjury risk following ACLR.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">After signing informed consent, participants underwent a comprehensive battery of assessments designed to evaluate multiple dimensions of sleep quality and lower-limb functional performance.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Pittsburgh Sleep Quality Index (PSQI): This validated self-report questionnaire was used to assess various aspects of sleep disturbances and overall sleep quality in the preceding month. Scores equal to or greater than 6 were considered indicative of poor sleep quality, reflecting issues such as latency, duration, efficiency, and disturbances during sleep.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Single-Leg Squat Test: This functional movement test was employed to evaluate dynamic knee valgus, a critical biomechanical factor linked to lower-limb injury risk . Participants performed controlled single-leg squats while clinicians observed and recorded knee alignment deviations, which serve as indicators of neuromuscular control deficits.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Landing Error Scoring System (LESS): To analyze jump-landing kinematics, this standardized observational tool quantified common movement errors during drop landings. The LESS provides insight into biomechanical factors that may contribute to injury risk by identifying faulty landing mechanics, such as excessive knee valgus or inadequate trunk control.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Y-Balance Test (YBT): This dynamic balance test assessed participants’ ability to maintain stability while reaching in multiple directions with one leg, reflecting neuromuscular coordination and proprioceptive integration critical for athletic performance and injury prevention.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Joint Position Sense Test (at 30° and 60° knee flexion): Proprioceptive accuracy was evaluated by measuring participants’ ability to actively replicate targeted joint angles without visual feedback. Angle reconstruction errors quantified deficits in joint position sense, which have important implications for motor control and stability following ACL reconstruction.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Data normality was confirmed via skewness/kurtosis tests. Simple linear regression (SPSS v27, p ≤ 0.05) examined relationships between sleep quality (predictor) and functional outcomes (dependent variables).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;">Findings</strong><span style="mso-fareast-font-family: 'Times New Roman';"><br></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">PSQI Scores: Nearly half of participants (mean score ~6, range: 2–14) had clinically significant sleep disturbances.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Correlations:</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Strongest correlation: Sleep quality and balance (r = +0.962).</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Negative correlations: Sleep disturbances worsened LESS scores (r = -0.768) and proprioceptive errors at 30° (r = -0.808) and 60° (r = -0.883).</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Regression Results: Sleep quality predicted:</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">92% of balance variance (YBT).</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">78% (60°) and 65% (30°) of proprioceptive error variance.</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">59% of landing kinematics (LESS).</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Poor sleep quality significantly correlated with impaired landing mechanics, balance deficits, and reduced proprioception in ACLR patients. These findings highlight sleep as a modifiable risk factor for secondary ACL injuries, emphasizing its role in rehabilitation and injury prevention strategies.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;">Conclusion</strong><span style="mso-fareast-font-family: 'Times New Roman';"><br></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study examined the relationship between sleep disturbances in male athletes with ACL reconstruction (ACLR) and dynamic knee valgus, landing kinematics, balance, and proprioception. Results demonstrated that poor sleep quality significantly predicted deficits in landing mechanics, balance, and joint position sense (30° and 60° knee flexion), highlighting its role as a modifiable risk factor for secondary ACL injuries.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Sleep disturbances likely impair neuromuscular, sensory, and motor systems, directly compromising athletic performance. Supporting studies Marwanasari et al., 2024; Erlacher, 2024) found that sleep deprivation negatively affects memory, pain perception, immunity, and metabolism, while improved sleep enhances cognitive and physical performance. Similarly, Fullagar et al. (2023) linked adequate sleep to better skill acquisition and tactical learning in athletes.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Physiologically, sleep is critical for recovery. The glymphatic system clears neurotoxic waste (e.g., beta-amyloid) during deep sleep, while cytokines and growth hormones produced during sleep aid immune function and cellular repair (Souza et al., 2023). Poor sleep disrupts these processes, impairing proprioceptive accuracy, balance, and neuromuscular control. Silva et al. (2021) emphasized extending nighttime sleep or adding naps to boost performance, aligning with our findings.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">In ACLR athletes with dynamic valgus, sleep-related deficits may exacerbate sensorimotor dysfunction. The brain integrates visual, vestibular, and proprioceptive inputs to coordinate movement; sleep deprivation likely disrupts this integration, increasing kinematic errors and balance instability. Checa et al. (2020) reported similar gait and balance impairments in sleep-deprived females, consistent with our Y-Balance and LESS results</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Article Message</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">This study </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">underscores</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> the </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">critical role</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> of sleep quality in preventing </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">secondary injuries. Routine and </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">seasonal sleep </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">assessments are</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> recommended </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">for athletes </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">to reduce sleep disturbances and injury risk. Future research should </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">explore</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> the </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">relationship</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> between sleep quality and injury </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">risk </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">during functional activities, incorporating laboratory </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">measurements</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">, biomarkers, postural analysis, sex differences, and </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">a range of </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">lower limb disorders across </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">different </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">age groups.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Ethical Considerations</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The study was approved </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">by the Research Ethics Committee</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> on 2024-05-25 </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">under the code of </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">IR.IAU.SRB.REC.1403.152.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Authors’ Contributions</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Mostafa Jalili Bafrouei</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> conceptualization, data collection, literature review, data analysis, manuscript writing, project administration.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Mohammadreza Seyedi</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> data collection, literature review, manuscript editing.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Seyed Hossein Mirkarimpour</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> data collection, literature review, manuscript revision.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">All authors reviewed and approved the final manuscript.</span><br><strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">Conflict of Interest</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The authors declare no conflict of interest related to this study</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Acknowledgments</span></strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The authors </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">extend</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> sincere gratitude to all participants</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"> and</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> staff at the physiotherapy and rehabilitation centers who supported this research, including Arvand Physiotherapy Center, Sarir Rehabilitation Center, Dr. Mohammad Ali Sazegari Ardakani, and Arad Hospital.</span><br><br><strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> </span></strong><br><span dir="LTR" style="font-size: 18.0pt; mso-bidi-font-size: 9.0pt; line-height: 107%; font-family: IRNazanin; mso-bidi-font-family: 'B Titr'; mso-bidi-language: FA;"> </span><strong style="mso-bidi-font-weight: normal;">Background and Purpose</strong><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Sleep, a vital biological need, occupies about 35% of human life and plays a crucial role in maintaining optimal physical, cognitive, and psychological health. For athletes, adequate sleep is essential as it enhances performance, promotes effective recovery, strengthens immune function, and facilitates learning and memory consolidation, while simultaneously reducing fatigue, mental stress, and risk of injury. However, athletes frequently face sleep disturbances due to factors such as high training loads, competition stress, frequent travel across time zones, and irregular daily schedules. These conditions often necessitate athletes to obtain 9–10 hours of sleep nightly to sustain optimal functioning. Sleep disorders including insomnia, sleep apnea, or circadian rhythm disruptions affect 30–45% of the global population and negatively influence neurological, endocrine, and motor functions, leading to impairments in balance, decision-making abilities, reaction times, and muscle strength.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study focuses specifically on poor sleep quality as a potential and modifiable risk factor for secondary anterior cruciate ligament (ACL) injuries in athletes. ACL injuries significantly compromise knee stability, proprioception, and lower-limb movement kinematics, which cumulatively increase the risk of reinjury during dynamic sports activities. Additionally, factors such as gender, age, incomplete or inadequate rehabilitation, and persistent fatigue can further elevate these risks. Post-ACL reconstruction, altered lower-limb kinematics characterized by increased knee valgus and reduced flexion angles might predispose athletes to secondary injuries. Given the severe physical, psychological, and economic consequences of failed ACL repairs, identifying modifiable risk factors such as sleep quality and disturbances is critically important. This research investigates the extent to which sleep disturbances exacerbate deficits in kinematics, balance, and proprioception, thereby contributing to the risk of secondary ACL injuries. The findings are expected to provide valuable insights for athletes, coaches, and clinicians and inform the development of targeted preventive strategies to reduce reinjury incidence and improve long-term athlete health and performance.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Materials and Methods</span></strong><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study employed a descriptive, applied, and within-group design to investigate the relationship between sleep quality and functional outcomes including kinematics, balance, and proprioception in male athletes with a history of anterior cruciate ligament reconstruction (ACLR). The target population consisted of men residing in Tehran who had undergone ACLR at least six months prior, experienced non-contact injury mechanisms, and consistently played football at least twice weekly. Using G*Power software with a power of 0.80 and an effect size of 0.60, a calculated sample size of 44 participants was determined and selected purposively based on strict inclusion criteria to ensure homogeneity.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Inclusion Criteria consisted of males aged between 25 and 35 years, with a normal BMI range of 18–25 kg/m², who had received hamstring autograft ACLR, exhibited positive dynamic knee valgus during single-leg squat assessments, did not use sedatives or psychiatric medications in the preceding three months, had engaged in a minimum of 50 hours of sports activity annually before ACLR, completed standardized post-ACLR rehabilitation protocols, and had no history of prior lower-limb surgeries other than ACLR, nor any multi-ligament or osteochondral injuries.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Exclusion criteria included any discomfort, pain, or injury occurring during testing sessions or inability to complete the full assessment protocols. Participants were actively recruited through collaboration with physiotherapy clinics and knee surgeons in Tehran, ensuring access to relevant patient populations. This carefully controlled sample allows for focused examination of how sleep quality correlates with critical functional parameters relevant to athletic performance and reinjury risk following ACLR.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">After signing informed consent, participants underwent a comprehensive battery of assessments designed to evaluate multiple dimensions of sleep quality and lower-limb functional performance.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Pittsburgh Sleep Quality Index (PSQI): This validated self-report questionnaire was used to assess various aspects of sleep disturbances and overall sleep quality in the preceding month. Scores equal to or greater than 6 were considered indicative of poor sleep quality, reflecting issues such as latency, duration, efficiency, and disturbances during sleep.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Single-Leg Squat Test: This functional movement test was employed to evaluate dynamic knee valgus, a critical biomechanical factor linked to lower-limb injury risk . Participants performed controlled single-leg squats while clinicians observed and recorded knee alignment deviations, which serve as indicators of neuromuscular control deficits.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Landing Error Scoring System (LESS): To analyze jump-landing kinematics, this standardized observational tool quantified common movement errors during drop landings. The LESS provides insight into biomechanical factors that may contribute to injury risk by identifying faulty landing mechanics, such as excessive knee valgus or inadequate trunk control.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Y-Balance Test (YBT): This dynamic balance test assessed participants’ ability to maintain stability while reaching in multiple directions with one leg, reflecting neuromuscular coordination and proprioceptive integration critical for athletic performance and injury prevention.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Joint Position Sense Test (at 30° and 60° knee flexion): Proprioceptive accuracy was evaluated by measuring participants’ ability to actively replicate targeted joint angles without visual feedback. Angle reconstruction errors quantified deficits in joint position sense, which have important implications for motor control and stability following ACL reconstruction.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Data normality was confirmed via skewness/kurtosis tests. Simple linear regression (SPSS v27, p ≤ 0.05) examined relationships between sleep quality (predictor) and functional outcomes (dependent variables).</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;">Findings</strong><span style="mso-fareast-font-family: 'Times New Roman';"><br></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">PSQI Scores: Nearly half of participants (mean score ~6, range: 2–14) had clinically significant sleep disturbances.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Correlations:</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Strongest correlation: Sleep quality and balance (r = +0.962).</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Negative correlations: Sleep disturbances worsened LESS scores (r = -0.768) and proprioceptive errors at 30° (r = -0.808) and 60° (r = -0.883).</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Regression Results: Sleep quality predicted:</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">92% of balance variance (YBT).</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">78% (60°) and 65% (30°) of proprioceptive error variance.</span><br><span style="font-size: 11.0pt; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';"> </span></span></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">59% of landing kinematics (LESS).</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Poor sleep quality significantly correlated with impaired landing mechanics, balance deficits, and reduced proprioception in ACLR patients. These findings highlight sleep as a modifiable risk factor for secondary ACL injuries, emphasizing its role in rehabilitation and injury prevention strategies.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;">Conclusion</strong><span style="mso-fareast-font-family: 'Times New Roman';"><br></span><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">This study examined the relationship between sleep disturbances in male athletes with ACL reconstruction (ACLR) and dynamic knee valgus, landing kinematics, balance, and proprioception. Results demonstrated that poor sleep quality significantly predicted deficits in landing mechanics, balance, and joint position sense (30° and 60° knee flexion), highlighting its role as a modifiable risk factor for secondary ACL injuries.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Sleep disturbances likely impair neuromuscular, sensory, and motor systems, directly compromising athletic performance. Supporting studies Marwanasari et al., 2024; Erlacher, 2024) found that sleep deprivation negatively affects memory, pain perception, immunity, and metabolism, while improved sleep enhances cognitive and physical performance. Similarly, Fullagar et al. (2023) linked adequate sleep to better skill acquisition and tactical learning in athletes.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">Physiologically, sleep is critical for recovery. The glymphatic system clears neurotoxic waste (e.g., beta-amyloid) during deep sleep, while cytokines and growth hormones produced during sleep aid immune function and cellular repair (Souza et al., 2023). Poor sleep disrupts these processes, impairing proprioceptive accuracy, balance, and neuromuscular control. Silva et al. (2021) emphasized extending nighttime sleep or adding naps to boost performance, aligning with our findings.</span><br><span style="font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman';">In ACLR athletes with dynamic valgus, sleep-related deficits may exacerbate sensorimotor dysfunction. The brain integrates visual, vestibular, and proprioceptive inputs to coordinate movement; sleep deprivation likely disrupts this integration, increasing kinematic errors and balance instability. Checa et al. (2020) reported similar gait and balance impairments in sleep-deprived females, consistent with our Y-Balance and LESS results</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Article Message</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">This study </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">underscores</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> the </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">critical role</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> of sleep quality in preventing </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">secondary injuries. Routine and </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">seasonal sleep </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">assessments are</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> recommended </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">for athletes </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">to reduce sleep disturbances and injury risk. Future research should </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">explore</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> the </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">relationship</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> between sleep quality and injury </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">risk </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">during functional activities, incorporating laboratory </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">measurements</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">, biomarkers, postural analysis, sex differences, and </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">a range of </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">lower limb disorders across </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">different </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">age groups.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Ethical Considerations</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The study was approved </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">by the Research Ethics Committee</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> on 2024-05-25 </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">under the code of </span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">IR.IAU.SRB.REC.1403.152.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Authors’ Contributions</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Mostafa Jalili Bafrouei</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> conceptualization, data collection, literature review, data analysis, manuscript writing, project administration.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Mohammadreza Seyedi</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> data collection, literature review, manuscript editing.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Seyed Hossein Mirkarimpour</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">:</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> data collection, literature review, manuscript revision.</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">All authors reviewed and approved the final manuscript.</span><br><strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">Conflict of Interest</span></strong><br><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The authors declare no conflict of interest related to this study</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">.</span><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 10.0pt; mso-bidi-font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> </span></strong><br><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">Acknowledgments</span></strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"><br></span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;">The authors </span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';">extend</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> sincere gratitude to all participants</span><span style="font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman';"> and</span><span style="mso-bidi-font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-bidi-font-family: Arial; mso-bidi-theme-font: minor-bidi;"> staff at the physiotherapy and rehabilitation centers who supported this research, including Arvand Physiotherapy Center, Sarir Rehabilitation Center, Dr. Mohammad Ali Sazegari Ardakani, and Arad Hospital.</span><br><br><strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> </span></strong><br><span dir="LTR" style="font-size: 18.0pt; mso-bidi-font-size: 9.0pt; line-height: 107%; font-family: IRNazanin; mso-bidi-font-family: 'B Titr'; mso-bidi-language: FA;"> </span>https://smj.ssrc.ac.ir/article_4542_7c33e57e3dbd8a52940fa1a963aa4a4a.pdfSport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622Coordination Analysis of Lower Limb Joints in Forward Lunge with and without Using TRXCoordination Analysis of Lower Limb Joints in Forward Lunge with and without Using TRX89110399710.22089/smj.2023.15213.1699FAFahimehKhoshmaramDepartment of Sport Biomechanics and Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran0000-0002-9322-1296HeydarSadeghiDepartment of Sport Biomechanics and Rehabilitation, Kinesiology Resaech Center, Kharazmi University, Tehran, Iran0000-0001-6563-9882RonaldSnarrDepartment of Kinesiology, Texas A&M University-Corpus Christi, Corpus Christi, USA0000-0002-0910-7045Journal Article20230703<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Over the past decades, various types of eccentric exercises have been developed and used for facilitating improvements in musculoskeletal function and prevention or rehabilitation of muscle and tendon injuries. One of these exercises is the forward lunge, which is broadly used within the sports community amid training and recovery as it is better suited to the movement patterns of everyday tasks and different sports, activates multiple muscle groups simultaneously, and requires less specialized equipment. Various types of forward lunges have long been used when prescribing exercises for the lower extremities depending on a person's specific needs</span><span dir="RTL" lang="AR-SA" style="font-size: 11.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">.</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">In recent years, instability resistance training has gradually gained importance over traditional type in the field of sports training and fitness activities because of its simplicity (since it requires only body weight as a load), its specificity, and its high transferability to actions in athletic competition. Performing closed-kinetic-chain exercises like forward lunge with an instability device such as TRX suspension trainer system can alter movement patterns and affect motor control requirements differently A review of the research background shows that despite the increasing tendency of people to use instability devices, not many studies have been conducted in this area and most research has been done in the area of muscle activity, while there is no study on movement patterns or joint coordination, and due to the lack of information or mixed results [2,4], the different aspects of this way of exercise are still in an aura of uncertainty, leading to confusion for instructors or clinicians when designing exercise programs. Therefore, the aim of this study was to analyze coordination of the lower limb joints in performing forward lunge with and without using TRX.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">A sample of 22 recreationally active female adults (mean height 164.9 ± 4.2 cm; mean body weight 60.6 ± 8.4 kg; mean age 25.45 ± 5.2 years) was recruited through a convenience sampling approach. Upon arrival at the laboratory, a 15-minute session of warm-up exercises was conducted and reflective markers (14-mm spheres) were placed (with double-sided tape) bilaterally over the landmarks [3]. Then, the random allocation of performance order was applied to each participant, who completed three repetitions of each exercise including conventional forward lunge, forward lunge by placing hands or foot inside the TRX rope. While performing exercises, kinematics of movements were collected using an 8-camera motion analysis system at 250 Hz (Oqus 5+, Qualisis). Analyzing motion data was conducted using The MATLAB software (The Mathworks Inc., Natick, MA). The lower limb was modeled as a composition of four fixed rigid segments, namely the pelvis, thigh, leg, and feet. Middle repetition of each exercise was interpolated and normalized to 100% of the movement cycle using spline. Then, angular displacement and velocity, range of motion, continuous relative-phase (CRP) angles and coordination variability of the joints of right leg of the subject, which correlates with the leading leg in all variations of forward lunge were calculated based on previous researches. In order to conduct a comparison of obtained values across different joints/exercises/phases repeated measures analysis of variance was employed. A post-hoc analysis was conducted utilizing Tukey's multiple comparison tests in order to identify notable variations. All statistical procedures were conducted using the SPSS platform for Windows (version 24. 0, SPSS Inc., located in Chicago, IL) and the predetermined level of significance was set at P < 0.05 for all statistical tests.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The obtained results show that knee range of motion is greater than hip and ankle range of motion in all exercises, but FLL shows decreased knee and ankle range of motion and increased hip ROM. However, no significant interaction between exercises was found. RMS values of angular velocity for lower extremity joints across demonstrates higher angular RMS values for hip and lower values for knee and ankle in comparison of FLL with other variations. That means the hip moves faster than the knee and ankle when doing the FLL exercise. The difference in angular velocity of joints between FL and FLH was significant. RMS and MARP values of CRP couplings show an in-phase mode during 100% of movement cycle. Analysis of coordination variability (CV) in sagittal plane for the joints shows a significant difference between exercises and phases.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The study analyzed the displacement curves and found similar patterns in all three types of lunges, with FLL targeting the hip and FLH targeting the foot flexors. While all three types of lunges are recommended for improving knee joint range of motion and muscle function, FLL is recommended for improving hip extensor function and FLH for improving foot flexor function and ankle joint range of motion. Also an in-phase movement is found for all three types of lunges for the hip/knee, hip/ankle, and knee/ankle joint pairs during the entire cycle of motion in the sagittal plane. The study also found that closed-kinetic chain exercises require more synchronized joint movement, while open-kinetic chain exercises allow for more independent movement. The study suggests that closed-kinetic chain exercises are more effective for improving lower limb muscle function.</span>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-family: 'B Nazanin';">Article</span></strong><strong><span dir="RTL" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; line-height: 107%; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';"> </span></strong><strong><span style="mso-bidi-font-family: 'B Nazanin';">Message<span style="mso-tab-count: 1;"> </span></span></strong>
<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; line-height: 107%; mso-bidi-font-family: 'B Nazanin';">Lunge is a closed kinetic chain exercise and is an essential part of most exercise programs. It is known as a knee-dominant movement. However, when performing the lunge exercise with the TRX strap, the range of motion in the hip joint increases, and the range of motion in the ankle joint decreases. Therefore, it can be said that the TRX lunge exercise can be more effective than other types of lunges in restoring the performance of the hip flexors in individuals diagnosed with weakness in the hip flexor muscles. Similarly, for individuals diagnosed with weakness in the plantar flexor muscles, the FLH exercise will be more effective. In addition, due to the increased variability in the ascending phase of various types of lunges, it is better for individuals with balance problems or muscle weakness to stand next to a support and ask for help if they slip or fall.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Ethical Considerations</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This study was granted approval by the institutional ethics commission (IR.KHU.REC.1400.026).</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Authors’ Contributions</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conceptualization:</span> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Collection: Fahimeh Khoshmaram,</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Analysis: Fahimeh Khoshmaram, Heydar Sadeghi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Manuscript Writing: Fahimeh Khoshmaram,</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Review and Editing: Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Responsible for funding:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram, Heydar Sadeghi</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Literature Review:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Project Manager:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Heydar Sadeghi</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Any other Contributions:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Conflict of Interest</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">We, the authers, declare that no conflicts of interest related to this research paper.</span>
<strong><span style="font-size: 10.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Acknowledgments</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The author(s) would like to express their sincere gratitude to all the participants for their valuable time and cooperation in this study.</span>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong><strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Over the past decades, various types of eccentric exercises have been developed and used for facilitating improvements in musculoskeletal function and prevention or rehabilitation of muscle and tendon injuries. One of these exercises is the forward lunge, which is broadly used within the sports community amid training and recovery as it is better suited to the movement patterns of everyday tasks and different sports, activates multiple muscle groups simultaneously, and requires less specialized equipment. Various types of forward lunges have long been used when prescribing exercises for the lower extremities depending on a person's specific needs</span><span dir="RTL" lang="AR-SA" style="font-size: 11.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">.</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">In recent years, instability resistance training has gradually gained importance over traditional type in the field of sports training and fitness activities because of its simplicity (since it requires only body weight as a load), its specificity, and its high transferability to actions in athletic competition. Performing closed-kinetic-chain exercises like forward lunge with an instability device such as TRX suspension trainer system can alter movement patterns and affect motor control requirements differently A review of the research background shows that despite the increasing tendency of people to use instability devices, not many studies have been conducted in this area and most research has been done in the area of muscle activity, while there is no study on movement patterns or joint coordination, and due to the lack of information or mixed results [2,4], the different aspects of this way of exercise are still in an aura of uncertainty, leading to confusion for instructors or clinicians when designing exercise programs. Therefore, the aim of this study was to analyze coordination of the lower limb joints in performing forward lunge with and without using TRX.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">A sample of 22 recreationally active female adults (mean height 164.9 ± 4.2 cm; mean body weight 60.6 ± 8.4 kg; mean age 25.45 ± 5.2 years) was recruited through a convenience sampling approach. Upon arrival at the laboratory, a 15-minute session of warm-up exercises was conducted and reflective markers (14-mm spheres) were placed (with double-sided tape) bilaterally over the landmarks [3]. Then, the random allocation of performance order was applied to each participant, who completed three repetitions of each exercise including conventional forward lunge, forward lunge by placing hands or foot inside the TRX rope. While performing exercises, kinematics of movements were collected using an 8-camera motion analysis system at 250 Hz (Oqus 5+, Qualisis). Analyzing motion data was conducted using The MATLAB software (The Mathworks Inc., Natick, MA). The lower limb was modeled as a composition of four fixed rigid segments, namely the pelvis, thigh, leg, and feet. Middle repetition of each exercise was interpolated and normalized to 100% of the movement cycle using spline. Then, angular displacement and velocity, range of motion, continuous relative-phase (CRP) angles and coordination variability of the joints of right leg of the subject, which correlates with the leading leg in all variations of forward lunge were calculated based on previous researches. In order to conduct a comparison of obtained values across different joints/exercises/phases repeated measures analysis of variance was employed. A post-hoc analysis was conducted utilizing Tukey's multiple comparison tests in order to identify notable variations. All statistical procedures were conducted using the SPSS platform for Windows (version 24. 0, SPSS Inc., located in Chicago, IL) and the predetermined level of significance was set at P < 0.05 for all statistical tests.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The obtained results show that knee range of motion is greater than hip and ankle range of motion in all exercises, but FLL shows decreased knee and ankle range of motion and increased hip ROM. However, no significant interaction between exercises was found. RMS values of angular velocity for lower extremity joints across demonstrates higher angular RMS values for hip and lower values for knee and ankle in comparison of FLL with other variations. That means the hip moves faster than the knee and ankle when doing the FLL exercise. The difference in angular velocity of joints between FL and FLH was significant. RMS and MARP values of CRP couplings show an in-phase mode during 100% of movement cycle. Analysis of coordination variability (CV) in sagittal plane for the joints shows a significant difference between exercises and phases.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The study analyzed the displacement curves and found similar patterns in all three types of lunges, with FLL targeting the hip and FLH targeting the foot flexors. While all three types of lunges are recommended for improving knee joint range of motion and muscle function, FLL is recommended for improving hip extensor function and FLH for improving foot flexor function and ankle joint range of motion. Also an in-phase movement is found for all three types of lunges for the hip/knee, hip/ankle, and knee/ankle joint pairs during the entire cycle of motion in the sagittal plane. The study also found that closed-kinetic chain exercises require more synchronized joint movement, while open-kinetic chain exercises allow for more independent movement. The study suggests that closed-kinetic chain exercises are more effective for improving lower limb muscle function.</span>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-family: 'B Nazanin';">Article</span></strong><strong><span dir="RTL" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; line-height: 107%; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';"> </span></strong><strong><span style="mso-bidi-font-family: 'B Nazanin';">Message<span style="mso-tab-count: 1;"> </span></span></strong>
<span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt; line-height: 107%; mso-bidi-font-family: 'B Nazanin';">Lunge is a closed kinetic chain exercise and is an essential part of most exercise programs. It is known as a knee-dominant movement. However, when performing the lunge exercise with the TRX strap, the range of motion in the hip joint increases, and the range of motion in the ankle joint decreases. Therefore, it can be said that the TRX lunge exercise can be more effective than other types of lunges in restoring the performance of the hip flexors in individuals diagnosed with weakness in the hip flexor muscles. Similarly, for individuals diagnosed with weakness in the plantar flexor muscles, the FLH exercise will be more effective. In addition, due to the increased variability in the ascending phase of various types of lunges, it is better for individuals with balance problems or muscle weakness to stand next to a support and ask for help if they slip or fall.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Ethical Considerations</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">This study was granted approval by the institutional ethics commission (IR.KHU.REC.1400.026).</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Authors’ Contributions</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conceptualization:</span> <span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Collection: Fahimeh Khoshmaram,</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Analysis: Fahimeh Khoshmaram, Heydar Sadeghi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Manuscript Writing: Fahimeh Khoshmaram,</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Review and Editing: Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Responsible for funding:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram, Heydar Sadeghi</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Literature Review:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Project Manager:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Heydar Sadeghi</span>
<span style="font-family: 'Vazirmatn',serif; color: black; background: white;">Any other Contributions:</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> Fahimeh Khoshmaram, Heydar Sadeghi, Ronald Snarr</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Conflict of Interest</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">We, the authers, declare that no conflicts of interest related to this research paper.</span>
<strong><span style="font-size: 10.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Acknowledgments</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The author(s) would like to express their sincere gratitude to all the participants for their valuable time and cooperation in this study.</span>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>https://smj.ssrc.ac.ir/article_3997_abec16f483abb4f1810ca029aadf8446.pdfSport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622Electromyography Activity of Selected Muscles of Shoulder Complex During Functional Movements in a Closed Chain Exercises Among Female Bodybuilders with Shoulder Impingement SyndromeElectromyography Activity of Selected Muscles of Shoulder Complex During Functional Movements in a Closed Chain Exercises Among Female Bodybuilders with Shoulder Impingement Syndrome105124493010.22089/smj.2025.17675.1792FAGitaBabal-MoradiM.Sc., Department of Sport Biomechanics, Faculty of Sports Sciences, Bu-Ali Sina University, Hamedan, Iran0009-0007-5211-8595MehrdadAnbarianProfessor, Department of Sport Biomechanics, Faculty of Sports Sciences, Bu-Ali Sina University, Hamedan, Iran0000-0002-3605-5586Journal Article20250114<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Shoulder impingement syndrome is a common complaint of shoulder pain in overhead athletes such as bodybuilders.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Shoulder exercises and overhead movements with heavy weights, which are usually accompanied by high stress and strain, occupy a significant part of the bodybuilding training program.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Impingement is associated with altered muscle activity of the shoulder complex.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">However, the pattern of muscle activity in these patients is controversial and inconsistent.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Functional training is one of the methods used in preventive and rehabilitation interventions in scapular stabilization.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">It is believed that functional training in a closed kinetic chain can contribute to the clinical treatment and recovery of athletes with shoulder impingement syndrome.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">However, there is a need to investigate different aspects of functional training in overhead sports, especially sports that place high stress and strain on the shoulder, such as bodybuilding.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">The aim of this study was to determine the electromyographic activity of selected muscles of the shoulder complex during some functional movements in female bodybuilders with shoulder impingement syndrome.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Ten healthy female bodybuilders and ten athletes with unilateral shoulder impingement syndrome of the dominant hand participated in this quasi-experimental study. Electromyograph</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">y</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> activity of the anterior deltoid, pectoralis major, serratus anterior, posterior deltoid, and upper and lower trapezius muscles during the performance of three functional movements common in bodybuilding in a closed-chain motion namely, Australian chain-up, push-up, and parallel bar dip, was recorded with an eight-channel biometric system (DataLink) at a sampling rate of 2000 Hz. Surface electrodes were placed on the muscles according to the European SENIAM protocol. Raw electromyographic signals were analyzed with DataLog software with a bandpass filter of 8 to 500 Hz. Then, the root mean square (RMS) of the filtered data was taken with a time window of 100 ms. One second of each data (the highest plateau of the curve) was separated and its data was extracted. It was determined by dividing the activity obtained for each muscle by MVIC and multiplying the obtained number by 100% of the activity of each muscle. The normalized activity of the studied muscles was extracted and used for statistical analysis. Also, directional co-contraction was calculated by dividing the mean of the RMS values of the antagonist muscle by the mean of the RMS values of the agonist muscles minus one. After ensuring the normality of the data distribution with the Shapiro-Wilk test, analysis of variance with repeated measures was used for data analysis (p<0.05).</span>
<strong><span style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results </span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;">In comparing muscle activity in three functional movements in the individuals with shoulder impingement syndrome, it was shown that the activity of the anterior deltoid muscle in the parallel bar dip movement was significantly higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the activity of this muscle in the push-up was higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;">. The posterior deltoid muscle in the parallel bar dip movement was significantly higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> was higher than the push-up. The pectoralis major muscle in the parallel bar dip movement showed significantly higher activity than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the mean activity of this muscle in the push-up movement was higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement. The serratus anterior muscle was significantly higher in the parallel bar dip movement than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the push-up movement. However, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement was not significantly different from the push-up movement. The activity of the upper part of the trapezius muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the parallel bar dip movement was significantly higher than the push-up movement. However, the activity of this muscle was not significant in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the parallel bar dip movement. The mean activity of the lower part of the trapezius muscle in the parallel bar dip movement was significantly higher than the push-up movement and the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement. Also, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement was higher than the push-up movement. The results showed that directional co-contraction in the push-up movement was higher in the healthy group than in the shoulder impingement syndrome group (p=0.01). No significant difference was observed for directional co-contraction in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and parallel bar dip movements (p=0.13 and p=0.64, respectively).</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">According to our findings, it can be concluded that the anterior shoulder muscles, including the pectoralis major and anterior deltoid, of bodybuilders with shoulder impingement syndrome are more active than healthy individuals when performing closed-chain movements, including </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">parallel bar dip</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">, push-up and </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">. This action can create a compensatory mechanism for other muscles of the shoulder complex and ultimately speed up the injury cycle. It is better for female bodybuilders with shoulder impingement syndrome to avoid closed-chain exercises until recovery. </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">If bodybuilders with shoulder impingement need to use closed-chain exercises to strengthen shoulder muscles, it is suggested to use the </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> exercise, which has the least amount of variation compared to the other two methods and may be safer for these individuals. Further study is warranted.</span>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-family: 'B Nazanin';">Article</span></strong><strong><span dir="RTL" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';"> </span></strong><strong><span style="mso-bidi-font-family: 'B Nazanin';">Message</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-ansi-language: EN; mso-bidi-language: AR-SA;">Choosing the right type of exercises for rehabilitation and designing a training program for athletes with shoulder impingement syndrome can prevent aggravation of the injury. It is recommended that fitness trainers use safe closed-chain exercises for this group of athletes, which place less pressure on the anterior shoulder joint.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Ethical Considerations </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This research received ethical approval from the Biomedical Research Ethics Committee at Bu-Ali Sina University, with the assigned Ethics Code: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">IR.BASU.REC.1401.017</span><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Authors’ Contributions</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conceptualization: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian, Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Collection: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Analysis: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Gita Babal-Moradi, Mehrdad Anbarian</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Manuscript Writing: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian, Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Review and Editing: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Conflict of Interest </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The researchers confirm that there are no conflicts of interest.</span>
<strong><span style="font-size: 10.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Acknowledgments </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study is extracted from Master degree of Sports Biomechanics at Bu-Ali Sina University. The authors would like to thank all subjects who participated in this study.</span>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>
<strong><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong><strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Background and Purpose</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Shoulder impingement syndrome is a common complaint of shoulder pain in overhead athletes such as bodybuilders.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Shoulder exercises and overhead movements with heavy weights, which are usually accompanied by high stress and strain, occupy a significant part of the bodybuilding training program.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Impingement is associated with altered muscle activity of the shoulder complex.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">However, the pattern of muscle activity in these patients is controversial and inconsistent.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Functional training is one of the methods used in preventive and rehabilitation interventions in scapular stabilization.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">It is believed that functional training in a closed kinetic chain can contribute to the clinical treatment and recovery of athletes with shoulder impingement syndrome.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">However, there is a need to investigate different aspects of functional training in overhead sports, especially sports that place high stress and strain on the shoulder, such as bodybuilding.</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">The aim of this study was to determine the electromyographic activity of selected muscles of the shoulder complex during some functional movements in female bodybuilders with shoulder impingement syndrome.</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Methods</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Ten healthy female bodybuilders and ten athletes with unilateral shoulder impingement syndrome of the dominant hand participated in this quasi-experimental study. Electromyograph</span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">y</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> activity of the anterior deltoid, pectoralis major, serratus anterior, posterior deltoid, and upper and lower trapezius muscles during the performance of three functional movements common in bodybuilding in a closed-chain motion namely, Australian chain-up, push-up, and parallel bar dip, was recorded with an eight-channel biometric system (DataLink) at a sampling rate of 2000 Hz. Surface electrodes were placed on the muscles according to the European SENIAM protocol. Raw electromyographic signals were analyzed with DataLog software with a bandpass filter of 8 to 500 Hz. Then, the root mean square (RMS) of the filtered data was taken with a time window of 100 ms. One second of each data (the highest plateau of the curve) was separated and its data was extracted. It was determined by dividing the activity obtained for each muscle by MVIC and multiplying the obtained number by 100% of the activity of each muscle. The normalized activity of the studied muscles was extracted and used for statistical analysis. Also, directional co-contraction was calculated by dividing the mean of the RMS values of the antagonist muscle by the mean of the RMS values of the agonist muscles minus one. After ensuring the normality of the data distribution with the Shapiro-Wilk test, analysis of variance with repeated measures was used for data analysis (p<0.05).</span>
<strong><span style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Results </span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;">In comparing muscle activity in three functional movements in the individuals with shoulder impingement syndrome, it was shown that the activity of the anterior deltoid muscle in the parallel bar dip movement was significantly higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the activity of this muscle in the push-up was higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;">. The posterior deltoid muscle in the parallel bar dip movement was significantly higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> was higher than the push-up. The pectoralis major muscle in the parallel bar dip movement showed significantly higher activity than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and the push-up. Also, the mean activity of this muscle in the push-up movement was higher than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement. The serratus anterior muscle was significantly higher in the parallel bar dip movement than the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the push-up movement. However, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement was not significantly different from the push-up movement. The activity of the upper part of the trapezius muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the parallel bar dip movement was significantly higher than the push-up movement. However, the activity of this muscle was not significant in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement and the parallel bar dip movement. The mean activity of the lower part of the trapezius muscle in the parallel bar dip movement was significantly higher than the push-up movement and the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement. Also, the activity of this muscle in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> movement was higher than the push-up movement. The results showed that directional co-contraction in the push-up movement was higher in the healthy group than in the shoulder impingement syndrome group (p=0.01). No significant difference was observed for directional co-contraction in the </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ansi-language: EN;"> and parallel bar dip movements (p=0.13 and p=0.64, respectively).</span>
<strong><span style="font-size: 10.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conclusion</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">According to our findings, it can be concluded that the anterior shoulder muscles, including the pectoralis major and anterior deltoid, of bodybuilders with shoulder impingement syndrome are more active than healthy individuals when performing closed-chain movements, including </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">parallel bar dip</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">, push-up and </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">. This action can create a compensatory mechanism for other muscles of the shoulder complex and ultimately speed up the injury cycle. It is better for female bodybuilders with shoulder impingement syndrome to avoid closed-chain exercises until recovery. </span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;">If bodybuilders with shoulder impingement need to use closed-chain exercises to strengthen shoulder muscles, it is suggested to use the </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Australian chain-up</span><span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-ansi-language: EN;"> exercise, which has the least amount of variation compared to the other two methods and may be safer for these individuals. Further study is warranted.</span>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-family: 'B Nazanin';">Article</span></strong><strong><span dir="RTL" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';"> </span></strong><strong><span style="mso-bidi-font-family: 'B Nazanin';">Message</span></strong>
<span lang="EN" style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-ansi-language: EN; mso-bidi-language: AR-SA;">Choosing the right type of exercises for rehabilitation and designing a training program for athletes with shoulder impingement syndrome can prevent aggravation of the injury. It is recommended that fitness trainers use safe closed-chain exercises for this group of athletes, which place less pressure on the anterior shoulder joint.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Ethical Considerations </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This research received ethical approval from the Biomedical Research Ethics Committee at Bu-Ali Sina University, with the assigned Ethics Code: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;">IR.BASU.REC.1401.017</span><span style="mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">.</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Authors’ Contributions</span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Conceptualization: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian, Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Collection: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Data Analysis: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Gita Babal-Moradi, Mehrdad Anbarian</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Manuscript Writing: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian, Gita Babal-Moradi</span>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Review and Editing: </span><span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Mehrdad Anbarian</span>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Conflict of Interest </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The researchers confirm that there are no conflicts of interest.</span>
<strong><span style="font-size: 10.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;"> </span></strong>
<strong><span style="mso-bidi-font-size: 12.0pt; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA;">Acknowledgments </span></strong>
<span style="font-size: 11.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study is extracted from Master degree of Sports Biomechanics at Bu-Ali Sina University. The authors would like to thank all subjects who participated in this study.</span>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>
<strong><span lang="FA" style="font-size: 13.0pt; mso-ansi-font-size: 12.0pt; font-family: 'B Nazanin'; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>
<strong><span dir="LTR" style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi;"> </span></strong>https://smj.ssrc.ac.ir/article_4930_aba22f748b1a6dff75bda4fd1ee9fe07.pdfSport Sciences Research InstituteStudies in Sport Medicine2322-1658174420250622Effects of Reactive Neuromuscular Exercise on Balance, Mobility, Fear of Fall and Muscle Strength in Older People with SarcopeniaEffects of Reactive Neuromuscular Exercise on Balance, Mobility, Fear of Fall and Muscle Strength in Older People with Sarcopenia111128490810.22089/smj.2025.18082.1813FAKomeilDashti RostamiDepartment of Motor Behavior and Biomechanics, Faculty of sports sciences, University of Mazandaran, Babolsar, Iran0000-0002-3467-2660RahelehGhaffari CheratiFaculty of Sport Science, Shomal University, Amol, Iran0000-0002-0760-3117DonyaKargaranFaculty of Sport Science, Shomal University, Amol, Iran0009-0002-0089-0974Journal Article20250602<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Background and Purpose</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Sarcopenia, or reduction of muscle mass, has been reported to occur in 50% of people over 80 years of age and is an important risk factor for functional disability and poor physical performance. Elderly people with sarcopenia experience problems such as balance, fear of falling, mobility, and decreased muscle strength. Previous studies have shown that reactive neuromuscular training (RNT) can lead to improved mobility and functional balance. RNT improves proprioception and dynamic stability, which can result in postural awareness, adaptations in balance, and improved position sense. RNT emphasizes precise body position to enhance dynamic stabilization of the muscular system, thus can improve functional activities. The purpose of this study was to investigate the effect of RNT exercises on functional mobility, balance, fear of falling, and muscle fitness of elderly people with sarcopenia.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Materials and Methods</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">In this semi-experimental study, 30 elderly people with the age range of 60 to 75 years (15 experimental group, N = 15; control group, N = 15) suffering from sarcopenia in Amol</span><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> city were recruited as samples with the confirmation of a physician. The sampling method was purposeful in which participants were chosen according to inclusion and exclusion criteria. G-Power software was used to determine the sample size with a statistical power of 80%, a confidence interval of 95%, and an effect size of 0.7. Sarcopenia was assessed according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Berg Balance Scale (BBS) was used to evaluate balance. Fear of falling was assessed using the FES-I (International Fall Efficiency Scale) questionnaire, which has 16 items related to 16 activities of daily living. Timed Up and Go test (TUG) was used to evaluate functional mobility. For performing the TUG test, the subject sits on a standard chair with a height of 46 cm, and the time required for the participant to get up from the chair, walk a distance of three meters, go around a specified place, and return to sit on the chair is recorded by a digital timer.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">For assessing upper and lower extremity muscle fitness, the 30-second bicep curl test and 30-second sit-to-stand test were used respectively. The muscular fitness of the upper limb was evaluated using the biceps curl with a dumbbell in 30 seconds. The weight of the dumbbell for men was 3.63 kg and for women 2.27 kg.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The experimental group performed eight weeks of reactive neuromuscular exercises, three sessions a week, a total of 24 sessions, each session lasting 45–60 minutes. The control group did not perform any activity during this period. The intensity of the exercises increased by manipulating the time of execution of the movement or the level and type of movement. In the final weeks, the maximum possible amount of pressure was considered according to the condition of the people. It should be noted that the intensity of the exercises used in the present study was recommended by the American College of Sports Medicine (ACSM).</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">SPSS software version 26 was utilized for data analysis. The normality of the data distribution was checked by the Shapiro-Wilk test. Analysis of covariance and Bonferroni’s post hoc test were used to compare research variables in two experimental and control groups at a significance level of p = 0.05.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Findings</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The two groups included 30 elderly people with an average age of 64.93 ± 4.11 years, height 169.23 ± 7.88 cm, weight 73.70 ± 8.14 kg, and body mass index 25.55 ± 1.85 kg/m². There was no significant difference in demographic characteristics between the two groups.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">ANCOVA results showed a significant difference between the experimental and control groups (F = 48.82, p = 0.001, η² = 0.64) in Berg Balance Scale. Specifically, the scores of the balance test in the experimental group increased significantly after the intervention. The results of the ANCOVA test showed a significant effect of RNT exercises on the functional mobility of the older people with sarcopenia (F = 64.26, p = 0.001, η² = 0.51). In fact, the time of the Timed Up and Go test was significantly reduced in the experimental group.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">There was no significant difference between the experimental and control groups in the fear of falling variable (F = 2.86, p = 1.02, η² = 0.11). Also, RNT exercises significantly improved the muscle fitness of the upper limb (η² = 0.59, p = 0.001, F = 29) and lower limb (η² = 0.53, p = 0.001, F = 30.06) in the experimental group compared to the control group.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conclusion<br></span></strong><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">It seems that RNT is effective in improving balance, mobility, and muscle fitness. RNT could improve the sense of proprioception and movement control pattern. These exercises affect balance and functional mobility and, by improving muscle fitness, help older people to cope better in activities of daily living. The strength of the upper and lower limbs is one of the important factors in maintaining the balance of older people with sarcopenia. Additionally, maintaining functional independence and performing daily necessary tasks by older people should be achieved by improving the level of mobility and functional balance. Considering the lack of effect of RNT on the fear of falling, it is suggested to consider more time for exercises in future research.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Article Message</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Reactive neuromuscular training can be considered an effective training modality for improving balance, joint mobility, and lower and upper limb strength in older adults with sarcopenia.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Ethical Considerations</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The research ethics code was obtained from the ethics committee of Shahroud University of Technology</span><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> with the number IR.SHAROODUT.REC.1404.003.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Authors’ Contributions</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conceptualization: Komeil Dashti Rostami, Raheleh Ghaffari<br>Data Collection: Donya Kargaran<br>Data Analysis: Komeil Dashti Rostami<br>Manuscript Writing: Komeil Dashti Rostami, Raheleh Ghaffari, Donya Kargaran<br>Review and Editing: Raheleh Ghaffari, Donya Kargaran<br>Project Manager: Komeil Dashti Rostami, Raheleh Ghaffari</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conflict of Interest</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The authors of the article declare that they have no conflicts of interest related to the present research.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Acknowledgments</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The authors express their gratitude and appreciation to all the dear elderly individuals who collaborated in this research project.</span>
<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"><span style="text-decoration: none;"> </span></span><strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Background and Purpose</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Sarcopenia, or reduction of muscle mass, has been reported to occur in 50% of people over 80 years of age and is an important risk factor for functional disability and poor physical performance. Elderly people with sarcopenia experience problems such as balance, fear of falling, mobility, and decreased muscle strength. Previous studies have shown that reactive neuromuscular training (RNT) can lead to improved mobility and functional balance. RNT improves proprioception and dynamic stability, which can result in postural awareness, adaptations in balance, and improved position sense. RNT emphasizes precise body position to enhance dynamic stabilization of the muscular system, thus can improve functional activities. The purpose of this study was to investigate the effect of RNT exercises on functional mobility, balance, fear of falling, and muscle fitness of elderly people with sarcopenia.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Materials and Methods</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">In this semi-experimental study, 30 elderly people with the age range of 60 to 75 years (15 experimental group, N = 15; control group, N = 15) suffering from sarcopenia in Amol</span><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> city were recruited as samples with the confirmation of a physician. The sampling method was purposeful in which participants were chosen according to inclusion and exclusion criteria. G-Power software was used to determine the sample size with a statistical power of 80%, a confidence interval of 95%, and an effect size of 0.7. Sarcopenia was assessed according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Berg Balance Scale (BBS) was used to evaluate balance. Fear of falling was assessed using the FES-I (International Fall Efficiency Scale) questionnaire, which has 16 items related to 16 activities of daily living. Timed Up and Go test (TUG) was used to evaluate functional mobility. For performing the TUG test, the subject sits on a standard chair with a height of 46 cm, and the time required for the participant to get up from the chair, walk a distance of three meters, go around a specified place, and return to sit on the chair is recorded by a digital timer.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">For assessing upper and lower extremity muscle fitness, the 30-second bicep curl test and 30-second sit-to-stand test were used respectively. The muscular fitness of the upper limb was evaluated using the biceps curl with a dumbbell in 30 seconds. The weight of the dumbbell for men was 3.63 kg and for women 2.27 kg.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The experimental group performed eight weeks of reactive neuromuscular exercises, three sessions a week, a total of 24 sessions, each session lasting 45–60 minutes. The control group did not perform any activity during this period. The intensity of the exercises increased by manipulating the time of execution of the movement or the level and type of movement. In the final weeks, the maximum possible amount of pressure was considered according to the condition of the people. It should be noted that the intensity of the exercises used in the present study was recommended by the American College of Sports Medicine (ACSM).</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">SPSS software version 26 was utilized for data analysis. The normality of the data distribution was checked by the Shapiro-Wilk test. Analysis of covariance and Bonferroni’s post hoc test were used to compare research variables in two experimental and control groups at a significance level of p = 0.05.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Findings</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The two groups included 30 elderly people with an average age of 64.93 ± 4.11 years, height 169.23 ± 7.88 cm, weight 73.70 ± 8.14 kg, and body mass index 25.55 ± 1.85 kg/m². There was no significant difference in demographic characteristics between the two groups.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">ANCOVA results showed a significant difference between the experimental and control groups (F = 48.82, p = 0.001, η² = 0.64) in Berg Balance Scale. Specifically, the scores of the balance test in the experimental group increased significantly after the intervention. The results of the ANCOVA test showed a significant effect of RNT exercises on the functional mobility of the older people with sarcopenia (F = 64.26, p = 0.001, η² = 0.51). In fact, the time of the Timed Up and Go test was significantly reduced in the experimental group.</span>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">There was no significant difference between the experimental and control groups in the fear of falling variable (F = 2.86, p = 1.02, η² = 0.11). Also, RNT exercises significantly improved the muscle fitness of the upper limb (η² = 0.59, p = 0.001, F = 29) and lower limb (η² = 0.53, p = 0.001, F = 30.06) in the experimental group compared to the control group.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conclusion<br></span></strong><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">It seems that RNT is effective in improving balance, mobility, and muscle fitness. RNT could improve the sense of proprioception and movement control pattern. These exercises affect balance and functional mobility and, by improving muscle fitness, help older people to cope better in activities of daily living. The strength of the upper and lower limbs is one of the important factors in maintaining the balance of older people with sarcopenia. Additionally, maintaining functional independence and performing daily necessary tasks by older people should be achieved by improving the level of mobility and functional balance. Considering the lack of effect of RNT on the fear of falling, it is suggested to consider more time for exercises in future research.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Article Message</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Reactive neuromuscular training can be considered an effective training modality for improving balance, joint mobility, and lower and upper limb strength in older adults with sarcopenia.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Ethical Considerations</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The research ethics code was obtained from the ethics committee of Shahroud University of Technology</span><span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> with the number IR.SHAROODUT.REC.1404.003.</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Authors’ Contributions</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conceptualization: Komeil Dashti Rostami, Raheleh Ghaffari<br>Data Collection: Donya Kargaran<br>Data Analysis: Komeil Dashti Rostami<br>Manuscript Writing: Komeil Dashti Rostami, Raheleh Ghaffari, Donya Kargaran<br>Review and Editing: Raheleh Ghaffari, Donya Kargaran<br>Project Manager: Komeil Dashti Rostami, Raheleh Ghaffari</span>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Conflict of Interest</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The authors of the article declare that they have no conflicts of interest related to the present research.</span>
<strong><span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> </span></strong>
<strong><span style="font-size: 12.0pt; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Acknowledgments</span></strong>
<span style="font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">The authors express their gratitude and appreciation to all the dear elderly individuals who collaborated in this research project.</span>
<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"><span style="text-decoration: none;"> </span></span>https://smj.ssrc.ac.ir/article_4908_1b33d16fc562464579b7199ca3114982.pdf