Effectiveness of backward walking training on knee osteoarthritis: A systematic review and meta-analysis / 中国组织工程研究

BACKGROUND: Backward walking is mainly considered to improve the symptoms of patients with knee osteoarthritis, which is used for rehabilitation and adjuvant treatment of knee osteoarthritis, but there is no evidence for evidence-based medicine. OBJECTIVE: To systematically review and quantify the evidence for the effect of backward walking on knee osteoarthritis in order to clarify the effect of backward walking on knee osteoarthritis. METHODS: PubMed, CINAHL, EMBASE, CNKI, CBM, WanFang and VIP were searched for relevant literature. After randomized controlled trials were screened, a meta-analysis was used to evaluate the effectiveness of backward walking on knee osteoarthritis. A total of 7 articles involving 231 patients were included in the result analysis. RESULTS AND CONCLUSION: Meta-analysis found that: compared with conventional treatment alone, the combination of conventional treatment with backward walking was better in pain relief [mean difference (MD)=-1.05, 95% confidence interval (CI) (-1.46,-0.63), P= 0.000 1], improving knee joint function [standardized mean difference (SMD)=-0.98, 95% CI (-1.33,-0.64), P < 0.000 01], enhancing quadriceps strength [SMD=1.07, 95% CI (0.52, 1.63), P=0.000 2] and improving timed up to go performance [MD=-0.41, 95% CI (-0.67, 0.16), P=0.001]. However, there was no significant difference in the WOMAC score after backward and forward walking [SMD=-0.43, 95% CI (-0.94,-0.08), P=0.10]. Meta-analysis results indicate that the combination of backward walking with conventional treatment has better clinical efficacy than conventional treatment alone for knee osteoarthritis patients. However, on the basis of conventional treatment, backward walking has comparable effects on WOMAC scores as compared with forward walking, which needs further large-sample high-quality randomized controlled trials to be verified.

A Study To Compare Retro-Walking (BACKWARD Walking) And Suboccipital Muscle Inhibition Technique In Hamstring Muscle Flexibility In Collegiate Students: An Experimental Study

Background: Tightness of hamstring is observed in a majority of the students. long duration sitting can be a contributory factor in hamstring tightness. Shortening of the hamstring has a negative impact on the posture of the pelvic region. The increase in stiffness of the hamstring may serve as a cause of low back pain and it is also a common characteristic of back pain patients. The increase in stiffness of the hamstring produces more burdens on the back and causes improper motion patterns in the lumbo-pelvic region. Methodology: For the study Total number of 30 subjects were randomly taken from The School of Physiotherapy at R.K.University and assigned to either group -A [suboccipital inhibition] or group-B [retro -walking (backward walking)] and there was given a treatment for 5 day with one session per day. Result: Data was analyzed by using SPSS software. For evaluation paired and unpaired T test used for analysis. Conclusion: It can conclude that has both techniques where improve hamstring muscles flexibility suboccipital muscles inhibition technique is more effective than the retro walking technique.

Effects of Backward Walking Training with Task Orientation on the Functional Gait of Children with Spastic Hemiplegia

PURPOSE: This study examined the effects of backward walking training with task orientation on the functional walking ability of children with cerebral palsy.METHODS: This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation facility with cross-over to the other intervention arm following a two-week break. For a total of 12 children with spastic hemiplegia cerebral palsy, the forward walking training group (n=6) underwent training three times a week for three weeks, 40 minutes a day, and the backward walking training group (n=6) was also trained under the same conditions. To identify the functional walking ability, variables, such as the walking speed, stride length, and step length, were measured using a walk analyzer (OptoGait, Microgate S.r.l, Italy).RESULTS: Both groups showed significant increases in walking speed, stride length, and step length (p<0.01). The backward walking group showed more significant improvement in the walking speed from pre- to post-test (p<0.05). The gait characteristics were similar in the two groups (stride length and step length) but the walking speed in the backward walking group showed a mean difference between the positive effects higher than the forward walking group.CONCLUSION: Task-oriented backward walking training, which was conducted on the ground, may be a more effective treatment approach for improving the walking functions of spastic hemiplegia children than forward walk training.

The impact of plantar pressure distribution characteristics on balance ability during backward walking / 医用生物力学

Objective To study the changes of plantar pressure during backward walking, so as to explore its effects on balance ability of human gait. Methods Plantar pressure measurement system (Pedar-X pressure insoles) was used to collect the plantar pressure data from 10 subjects during forward walking and backward walking, respectively. The experiment was conducted on the treadmill, and the forward walking was set as the control group. According to the test conditions and intuitive feeling of test participants, 4 speed values (2.0, 2.5, 3.0, 3.5 km/h) were selected to carry out the experiment under two walking modes, respectively. The changes in parameters such as plantar pressure center trajectory, plantar pressure and foot-ground contact time under different speed were analyzed. Results Under two walking modes at different walking speed, subjects showed different plantar pressure during walking. During backward walking, the plantar pressure center transferred from the front foot to the heel and from inside to outside. Compared with forward walking, the plantar pressure during backward walking decreased significantly while the foot-ground contact time increased. Conclusions The study on pressure distribution during backward walking contributes to comprehensively understanding the mechanism of dynamic balance and provides a new perspective for related study on walking stability.

Comparison of biomechanical characteristics of the knee joint during forward walking and backward walking / 医用生物力学

Objective To compare biomechanical characteristics of the knee joint during forward walking and backward walking. Methods Temporal-spatial, kinematics, kinetics parameters of 13 healthy young male volunteers were collected and compared by 3D motion capture system Vicon T40 and force platforms AMTI OR6-7. Results Compared with forward walking, the speed, cadence and stride length significantly decreased, while the gait cycle and stance phase percentage in gait cycle significantly increased during backward walking. In the sagittal plane, the range of motion (ROM), the maximum flexion/extension moment of the knee were smaller during backward walking. In the frontal plane, the ROM of knee varus/valgus during backward walking decreased, and the peak value of knee adduction moment significantly reduced in the early stance phase while significantly increased in the late stance phase of backward walking. The peak value of ground reaction force (GRF) was significantly larger in the early stance phase while smaller in the late stance phase during backward walking than that during forward walking. Conclusions The biomechanical characteristics of the knee joint during forward walking and backward walking are significantly different. Compared with forward walking, backward walking is helpful to reduce the medial compartment load in the early stance phase. Further study will be needed to investigate the effects of backward walking on knee joint loading in the late stance phase.

Características espaço-temporais do andar para trás em indivíduos com hemiparesia / Spatial temporal characteristics of backward walking in individuals with hemiparesis

O objetivo do presente estudo foi comparar as variáveis espaço-temporais entre o andar para frente (AF) e para trás (AT) em indivíduos com hemiparesia. Dez participantes com hemiparesia crônica (30,6±25,1 meses), comprometimento motor leve (20-31 pontos no Fugl-Meyer-membro inferior), bom equilíbrio (escore=50±7 na escala de Berg) e marcha independente (capaz de caminhar 10 metros sem auxilio) foram filmados caminhando em velocidade confortável, com marcadores reflexivos nos maléolos laterais. As variáveis comprimento, duração e velocidade da passada, bem como duração do apoio foram analisadas pela ANOVA com 2 fatores: tarefa e membro inferior. O comprimento da passada foi menor (~44cm) no AT do que no AF (F(1,18)=130,94; p≤0,001), assim como a velocidade da passada (F(1,18)=163,78;p≤0,001) e da marcha (t19=10,99;p≤0,001). A duração da passada e do apoio foram respectivamente maiores, ~0,18s e ~8%, no AT do que no AF, (F(1,18)=11,98; p=0,003; F(1,18)=32,00; p≤0,001, respectivamente). Embora o comprimento da passada do AT seja reduzido, o maior tempo do MI parético suportando o peso do corpo no AT pode ser um indicador relevante na reabilitação motora.

The present study aimed to compare spatial temporal variables between forward (FW) and backward walking (BW) in individuals with hemiparesis. Ten adults with chronic hemiparesis (30.6±25.1 months), mild motor impairment (20-31 points on Fugl-Meyer lower limb test), good balance (score=50±7 in the Berg scale) and independent walking (able to walk 10 meters without aid) were videotaped walking at comfortable speed with reflexive markers placed on lateral malleolus. The variables stride length, duration and speed and stance phase duration were analyzed with a two-way ANOVA: task and lower limb (LL). Stride length was lower (~44cm) in BW than in FW (F(1,18)=130,94; p≤0,001), as well as for stride (F(1,18)=163,78;p≤0,001) and walking speed (t19=10,99;p≤0,001). Stride and stance duration were ~0,18s e ~8%, respectively larger in BW than in FW (F(1,18)=11,98; p=0,003; F(1,18)=32,00; p≤0,001, respectively). Although the stride length in BW was reduced, the fact that the affected LL remained longer in stance in BW compared to FW indicates that the BW might be a relevant parameter in motor rehabilitation.

The Effect of Forward and Backward Treadmill walking Training on Muscular Strength of Lower Extremities before and after Exhausting Exercise / 대한스포츠의학회지

The purpose of this study was to investigate the physiological effects of forward and backward walking training on lower extremity muscle strength before and after exhausting exercise. Fourteen healthy male adults were randomly divided into backward walking (BW, n=7) and forward walking (FW, n=7) training groups. Each group took part in pre-test consisted of knee extensor and flexor isokinetic peak torque (PT), total work (TW), electromyography (EMG) before and after exhausting exercise. Exhausting exercise was used to measure lower extremity endurance, which is incremental treadmill running using the Bruce protocol. The BW and FW training groups participated in a 6 weeks training program, consisted of 3 sessions per week for a total of 18 sessions. After finishing the training program, the post-test was performed using the same method. BW training group showed significant increases in knee extensor/flexor PT (4.6%/13.9%), TW (17.34%), EMG (35.9%) before exhausting exercise and PT (23.9%/18.8%), TW (46.7%), EMG (59.8%) after exhausting exercise. But FW training group did not show a significant increase in knee extensor/flexor PT (0.1%/3.2%), TW (1.8%), EMG (10.9%) before exhausting exercise and PT (2%/1%), TW (5.6%), EMG (17.2%) after exhausting exercise. BW training has positive effects on lower extremity muscle strength, especially muscle endurance that is important to prevent muscle weakness during competitive sports.

Interactive Effects of Forward, Backward Walking Exercise and Pelvic Floor Muscle Exercise on Sexual Function and Functional Fitness in the Elderly Male Population

BACKGROUND: To assess the effect of forward, backward walking exercise and pelvic floor muscle exercise on sexual function and functional fitness in elderly males. METHODS: Twenty two elderly males participated in this study. They were divided into two groups. The Complex Exercise(CE) group(n=11) performed the forward, backward walking exercise(3 days/week, 12 weeks) and pelvic floor muscle exercises(PFME; 5 days/week, 12 weeks). The PFME group(n=11) only performed PFME(5 days/week, 12 weeks). Both groups performed the PFME in the same manner. Outcomes were evaluated by IIEF-5(5-item version of the interna- tional index of erectile function), 6min walk, and 30sec & 1min sit-to-stand before exercise training, and at week 4, week 8, and week 12. RESULTS: Total scores and erectile function scores had significant interaction effect(p<0.05) in group and period. 6min walk wassignificantly different(p<0.05) in exercise period and 30sec(p<0.001) & 1min sit-to-stand(p<0.01) had signi- ficant interaction effectin group and period. CONCLUSION: Three months of forward, backward walking and pelvic floor muscle exercises did not have significant positive effects on sexual function and functional fitness in elderly males.

Changes of Cardiopulmonary Response and Serum Lipid Level after Backward Walk Training

OBJECTIVE: The purpose of this study was to examine the changes of cardiopulmonary response and serum lipid level after backward walking training in healthy male college students. METHOD: Subjects were ten healthy male college students. Maximal heart rate and VO2max were determined for each subject by administering a Bruce treadmill exercise test after backward walking training during eight weeks. Wilcoxon signed rank test was used to evaluate the changes of the backward walk training. RESULTS: The study showed that maximal heart rates were 163.7 beat/min in pre-training and 175.8 beats/min in post- training; in contrast, resting heart rates were 72 beat/min in pre-training and 67 beat/min in post-training. The maximal oxygen consumptions were 2111 ml/min in pre-training and 2521 ml/min in post-training. There were significant differences (p<0.05) in maximal heart rate, heart rate ratio of maximal heart rate (% HR), oxygen consumption, and oxygen consumption ratio of maximal oxygen consumption (% VO2max) between the pre and post-training. The HDL cholesterol level was 42.8 mg/dl in pre-training and 58.0 mg/dl in post-training. There was significant increased of HDL cholesterol in post-training. CONCLUSION: We concluded that 5 km/hr backward walk training for eight weeks was an effective exercise program to increase in aerobic capacity of the male college students.

Comparison of Heart Rate and Oxygen Consumption between Forward and Backward Walking

OBJECTIVE: The purpose of this study was to investigate the changes of oxygen consumption and heart rate at forward and backward treadmill walking in healthy male college students. METHOD: Subjects were composed of twenty healthy male college students. The oxygen consumption, oxygen consumption ratio of maximal oxygen consumption (VO2max%) and heart rate, heart rate ratio of maximal heart rate (HRmax%) were measured for each subjects by administering a treadmill exercise test at 5 km/hr speed of forward and backward walking. Paired t-test was used to evaluate the difference of the forward and backward walking. RESULTS: The study showed that heart rate and HRmax% were 120.9 beat/min, 61.6% in forward walking, and 166.1 beats/min, 84.3% in backward walking, respectively. The oxygen consumption and VO2max% were 15.9 ml/kg/min, 37.3% in forward walking, and 23.6 ml/kg/min, 55.8% in backward walking, respectively. CONCLUSION: We concluded that 5 km/hr backward walking was more effective exercise program than forward walking to promote health in the college students.