Effects of Backward Walking on External Knee Adduction Moment and Knee Adduction Angular Impulse in Individuals with Medial Knee Osteoarthritis.
Level 2 - randomized trial
Randomized within-subject crossover biomechanical trial
PubMed 41155055 · doi:10.3390/bioengineering12101057
What was done
Thirty-two participants with medial knee osteoarthritis completed three-dimensional gait analysis under three randomized conditions: self-selected speed forward walking, self-selected speed backward walking, and speed-controlled forward walking (matched within 95% to 105% of backward walking speed). Biomechanical outcomes included the first and second peaks of external knee adduction moment (EKAM), first peak of external knee flexion moment (EKFM), and knee adduction angular impulse (KAAI).
What was found
Backward walking significantly reduced the first peak of EKAM and the KAAI compared with both self-selected forward walking and speed-controlled forward walking (p < 0.001). Both backward walking and speed-controlled forward walking significantly reduced the first peak of EKFM compared to self-selected forward walking (p < 0.001). Backward walking did not significantly reduce the second peak of EKAM compared to either forward walking condition (p > 0.05). Exact numerical values and effect sizes were not reported in the abstract.
Why it matters
Lowering the knee adduction moment and angular impulse reduces medial compartment compressive load, suggesting backward walking may be a viable low-load gait strategy for medial knee osteoarthritis rehabilitation.
Limits
The abstract does not provide exact numerical values or effect sizes. The sample size is modest (n = 32), and the study assessed only acute, in-lab biomechanics rather than long-term clinical outcomes like pain, disease progression, or fall risk.
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