Effectiveness of backward walking exercises combined with conventional rehabilitation programs on managing pain intensity and disability in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 40924430 · doi:10.1080/09593985.2025.2550532
What was done
A systematic review and random-effects meta-analysis following PRISMA guidelines evaluated randomized controlled trials (searched through June 2025) assessing backward walking exercise combined with conventional rehabilitation for knee osteoarthritis. Primary outcome was pain intensity and secondary outcome was disability, standardized as Hedges' g. Subgroup analyses evaluated walking speeds, surfaces, and control group characteristics.
What was found
Based on 13 randomized controlled trials, backward walking exercise combined with conventional rehabilitation significantly reduced pain intensity (Hedges' g = -0.997, 95% CI: -1.373 to -0.620) and improved disability (Hedges' g = -1.015, 95% CI: -1.326 to -0.703). Subgroup analyses showed larger effect sizes for comfortable walking speed and treadmill walking, with significant differences across all control group comparisons (p < .05).
Why it matters
Adding backward walking to standard rehabilitation protocols provides substantial improvements in pain relief and functional capacity for patients with knee osteoarthritis.
Limits
The total number of participants was not reported in the abstract. Standalone efficacy, long-term durability of outcomes, and formal certainty of evidence ratings were not assessed.
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