Effect of Pilates exercises on knee alignment during movement in young adults with flat foot

INTERVENTION: Intervention1: Pilates‐based exercise program: Exercises include: Pilates exercises: Swimming, Side‐kick, Roll‐up, Open V, One‐leg kick, Cleaning the floor (with progression/modification) Core stabilization: Abdominal bracing, pelvic tilt, static curl‐up Lower‐limb strengthening: Hip abduction and extension Foot‐specific exercises: Short foot exercise, toe spread, hallu Xextension Ankle mobility exercises: Dorsiflexion and plantarflexion Dosage: Frequency: 3 sessions per week Duration: 4 weeks Repetitions and progression as per protocol Control Intervention1: Conventional physiotherapy exercise program: Exercises include: Ankle exercises: Dorsiflexion and plantarflexion Foot strengthening: Short foot exercise, toe spread, hallu Xextension Core activation: Abdominal bracing, pelvic tilt Hip strengthening: Hip abduction and extension Dosage: Frequency: 3 sessions per week Duration: 4 weeks CONDITION: Health Condition 1: M00‐M99‐ Diseases of the musculoskeletal system and connective tissue PRIMARY OUTCOME: Frontal Plane Projection Angle (FPPA) ; ; FPPA will be measured during single‐leg squat and step‐down tasks using 2D video analysis with Kinovea software. ; Reflective markers will be placed on anatomical landmarks (ASIS, midpoint of patella, and ankle joint center) to calculate the knee valgus angle. ; Measurements will be recorded at baseline and after 4 weeks of intervention.Timepoint: Pre 0 th week ; Post 4th week SECONDARY OUTCOME: Foot Posture Inde X(FPI‐6) ; Used to assess the degree of flat foot posture. ; Si Xcriteria will be scored to classify foot posture. ; Measurements will be taken before and after intervention. ; Y‐Balance Test ; Used to assess dynamic balance in anterior, posteromedial, and posterolateral directions. ; Reach distances will be recorded and normalized. ; Measurements will be taken at baseline and after 4 weeks.Timepoint: Pre 0 th week ; Post 4th week INCLUSION CRITERIA: Age between 18to25 years. Diagnosed with flat foot (medial longitudinal arch present in open kinetic chain and reduced or absent in closed kinetic chain). Foot Posture Inde X(FPI‐6) score more or equal 6 Navicular drop grater than 10 mm. Body Mass Inde X(BMI) between 18.5 to 24.9 . Able to perform Pilates exercises, single leg squat or and step down tasks independently. No current pain or injury that limits participation in exercise.