Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial).
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 30967128 · doi:10.1186/s12891-019-2537-9
What was done
A 3-arm, single-blinded randomized controlled trial evaluated 68 participants (mean age 55.6 years; 38 female) with knee osteoarthritis at King Saud University outpatient physiotherapy department in Saudi Arabia. Participants were randomized to routine physiotherapy alone (control group: open and closed kinetic chain exercises) or routine physiotherapy plus 10 minutes of supervised retro (backward) walking or forward walking, 3 days per week for 6 weeks. Primary outcomes were pain intensity measured on a numerical rating scale and knee function measured by the WOMAC index. Secondary outcomes were quadriceps muscle strength and timed up and go test performance. All outcomes were analyzed by intention-to-treat at baseline and 6 weeks.
What was found
Week 6 completion rates were 91% in the retro walking group, 87% in the forward walking group, and 82% in the control group. In intention-to-treat analysis, the retro walking group demonstrated significantly greater improvements than the control group across all endpoints: pain intensity mean change was 1.8 versus 1.0 (p = 0.01); functional disability mean change was 4.8 versus 2.2 (p = 0.008); quadriceps strength mean change was 1.7 kg versus 0.7 kg (p = 0.008); and timed up and go test mean change was 0.6 seconds versus 0.1 seconds (p = 0.003). Specific numerical comparisons between retro walking and forward walking were not reported in the abstract.
Why it matters
Adding brief sessions of backward walking to standard exercise therapy provides modest additional benefits in pain relief, quadriceps strength, and mobility over standard physiotherapy alone in individuals with knee osteoarthritis.
Limits
The study had a small sample size (n = 68) from a single center and a short 6-week intervention without long-term follow-up. Participants could not be blinded to exercise assignment, and the abstract omits specific numerical comparisons between the retro walking and forward walking groups.
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