Clinical Implications of Prolonged Squat Sitting on Balance in Healthy Young Adults

Abstract

Background: Prolonged squat sitting remains a common sitting position in many occupational and domestic settings, especially in Asian populations. Although these deep flexion sitting postures are considered functionally convenient and culturally familiar, they can put substantial mechanical load on the knee and ankle joints, impact lower-limb muscle activity and disturb proprioceptive input. The effects of prolonged squat sitting on balance remain clinically important yet less focused in research studies although impaired balance may increase the risk of instability, slips, falls and work related injury. Objective: To examine the immediate effects of prolonged squat sitting on static and dynamic balance in healthy young adults. Methods: This pre-post experimental study recruited 30 asymptomatic participants aged 17–25 years from Karachi, Pakistan, using convenient sampling. Participants were made to maintain a deep squat sitting position for 30 minutes per day for three consecutive days. Static balance on each leg was assessed using Stork Stand Test (SST), and dynamic balance was assessed through Star Excursion Balance Test (SEBT). Pre- and post-intervention scores were analyzed in SPSS version 21 using descriptive statistics and within-subject comparisons. Statistical significance was set at p < 0.05. Results: The mean age of the sample was 20.53 ± 1.43 years; 56.7% were males and 43.3% were females. Static balance improved slightly after squat sitting, increasing from 21.50 to 23.28 seconds on the right leg and from 18.52 to 19.04 seconds on the left leg. On the other hand, dynamic balance declined across most SEBT directions after the intervention. For the right leg, normalized reach distance decreased in seven of eight directions while for the left leg, similar reductions in reach were observed in most directions, with only minimal directional improvement in the medial plane. Percentage summaries showed an overall decline of 6.34% for the right leg and 6.78% for the left leg. The source analysis reported statistically significant pre-post differences for static balance and all dynamic balance directions. Conclusion: Prolonged squat sitting appears to compromise dynamic balance more consistently than static balance in healthy young adults. Even when absolute changes are modest, the observed decline in dynamic balance has practical implications for occupations as well as daily activities that require repeated or sustained deep flexion sitting postures. Regular posture variation, task modification and conditioning of lower-limb endurance and balance should be incorporated to minimize functional instability.