Introduction: The sedentary lifestyle resulting from long-term video game playing has presented the musculoskeletal system of the young generation with serious biomechanical challenges and injuries. Despite the predominant focus of previous studies on upper limb and cervical-dorsal spine abnormalities, the present study was designed and implemented with the aim of comparing the frequency and severity of lower limb postural and musculoskeletal abnormalities between adolescent gamers and non-gamers.

Methods: This observational and cross-sectional comparative study was conducted on 40 participants (12 to 20 years old) in two independent groups of 20 including gamers and non-gamers. Assessments included measurement of lumbar lordosis, assessment of pelvic tilt, severity of crossed knee, navicular bone loss, and functional tests to measure lower limb muscle shortening (Thomas test, active knee extension, and lunge). Data were analyzed using two-way analysis of variance.

Results: Compared to the non-gamers, the gamer group showed significantly higher values in lumbar lordosis, anterior pelvic tilt, iliopsoas muscle shortening, and knee clubbing(P<0.001). However, no significant differences were found in more distal variables such as navicular depression, ankle dorsiflexion range, rectus femoris shortening, and hamstring flexibility between the two groups. The studies showed that gender had no significant main or interaction effect on these abnormalities.

Discussion: The results showed that prolonged sitting in gamers is associated with postural changes in the flexors, while it is less associated with more distal structures in the short term. Specialists can use these findings to design ergonomic programs and pelvic stabilization exercises for the rehabilitation of this group.