Bulletin of Rehabilitation MedicineBulletin of Rehabilitation Medicine2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology63262710.38025/2078-1962-2024-23-2-42-48Review ArticleArticlesPossibilities of backward walking application in the rehabilitation of patients with gonarthrosis: reviewhttps://orcid.org/0000-0002-3403-0713KlemenovAlexey V.klemenov_av@list.ruPrivolzhsky Research Medical University2405202423242482405202424052024Copyright © 2024, Klemenov A.V.2024<p><bold>INTRODUCTION.</bold> Osteoarthritis of the knee joint or gonarthrosis (GA) is one of the most common joint pathologies. The medical and social significance of GA is associated with its high prevalence and a significant percentage of premature disability and a significant deterioration in the quality of life due to persistent pain syndrome. Modern treatment of patients with GA includes a combination of pharmacological and non-pharmacological methods; physical therapy is the leading method of non-drug therapy. By now, a number of studies have been conducted to research the effectiveness of backward walking (BW) in people with GA.</p>
<p><bold>AIM.</bold> Analysis of scientific data on the possibilities of using BW in the rehabilitation of patients with GA.</p>
<p><bold>MATERIALS AND METHODS.</bold> A systematic search of literary sources by keywords was carried out: “backward walking”, “gonarthrosis”, “knee osteoarthritis”, “knee joint”, “rehabilitation”, “physical therapy”.</p>
<p><bold>DISCUSSION.</bold> Recently, backward locomotion is increasingly used in medicine. Kinetic and kinematic analysis during BW showed a number of advantages over the usual method of movement, which can be successfully used for rehabilitation of patients with GA. BW is associated with less overload on knee joints. It is also one of the few natural ways of strengthening the quadriceps. It prevents excessive stretching of the anterior cruciate ligament and improves the stability of the knee joint. BW leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity.</p>
<p><bold>CONCLUSION.</bold> There is evidence that adding BW to conventional physiotherapy treatment may further reduce pain, functional disability and improve the strength of the quadriceps muscles.</p>backward walkingrehabilitationphysical therapygonarthrosisosteoarthritisknee jointreviewобратная ходьбареабилитациялечебная физкультурагонартрозостеоартритколенный суставобзор литературы[Галушко Е.А., Насонов Е.Л. Распространенность ревматических заболеваний в России. Альманах клинической медицины. 2018; 46(1): 32–39. https://doi.org/10.18786/2072-0505-2018-46-1-32-39 [Galushko E.A., Nasonov E.L. Galushko E.A., Nasonov E.L. Prevalence of rheumatic diseases in Russia. Almanac of Clinical Medicine. 2018; 46(1): 32–39. https://doi.org/10.18786/2072-0505-2018-46-1-32-39 (In Russ.).]][Остеоартрит коленного сустава. Алгоритмы диагностики и лечения. Терапия. 2023; 9(4S): 164–188. https://clck.ru/3AjDBo [Osteoarthritis of the Knee Joint. Algorithms of Diagnosis and Treatment. Therapy. 2023; 9(4S): 164–188. https://clck.ru/3AjDBo (In Russ.).]][Маргазин В.А., Ачкасов Е.Е., Коромыслов А.В. (ред.) Лечебная физкультура при заболеваниях суставов. Санкт-Петербург. СпецЛит. 2017: 223 с. [Margazin V.A., Achkasov E.E., Koromyslov A.V. (eds.). Lechebnaja fizkul’tura pri zabolevanijah sustavov. Saint-Peterburg. SpecLit. 2017: 223 p. (In Russ.).]][Osthoff A.K., Juhl C.B., Knittle K., et al. Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open. 2018; 4(2): e000713. https://doi.org/10.1136/rmdopen-2018-000713][Goh S.L., Persson M.S.M., Stocks J., et al. Relative efficacy of different exercises for pain, function, performance and quality of life in knee and hip osteoarthritis: systematic review and network metaanalysis. Sports Medicine. 2019; 49(5): 743–761. https://doi.org/10.1007/s40279-019-01082-0][Tanaka R., Ozawa J., Kito N., Moriyama H. Effects of exercise therapy on walking ability in individuals with knee osteoarthritis: a systematic review and meta-analysis of randomised controlled trials. Clinical Rehabilitation. 2016; 30(1): 36–52. https://doi.org/10.1177/0269215515570098][Wu Y., Lei C., Huangfu Z., et al. Effect of backward walking training on knee osteoarthritis: protocol of a systematic review and meta-analysis. BMJ Open. 2020; 10(10): e040726. https://doi.org/10.1136/bmjopen-2020-040726][Abdel-Aziem A.A., Abdelraouf O.R., El-Basatiny H.M.Y., Draz A.H. The Effects of Stabilization Exercises Combined With Pelvic Floor Exercise in Women With Nonspecific Low Back Pain: A Randomized Clinical Study. Journal of Chiropractic Medicine. 2021; 20(4): 229–238. https://clck.ru/3AjDLE][Uthoff A., Zois J., Van Den Tillaar R., Nagahara R.J. Acceleration mechanics during forward and backward running: A comparison of step kinematics and kinetics over the first 20 m. Journal of Sports Sciences. 2021; 39(16): 1816–1821. https://doi.org/10.1080/02640414.2021.1898193][Cha H.G., Kim T.H., Kim M.K. Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science. 2016; 28(6): 1901–1903. https://doi.org/10.1589/jpts.28.1901][Donno L., Monoli C., Frigo C.A., Galli M. Forward and Backward Walking: Multifactorial Characterization of Gait Parameters. Sensors. 2023; 23(10): 4671. https://doi.org/10.3390/s23104671][Soda N., Ueki T., Aoki T. Three-dimensional motion analysis of the ankle during backward walking. Journal of Physical Therapy Science. 2013; 25(6): 747–749. https://doi.org/10.1589/jpts.25.747][Shigemori K., Nagino K., Nakamata E., et al. Motor Learning in the Community-dwelling Elderly during Nordic Backward Walking. Journal of Physical Therapy Science. 2014; 26(5): 741–743. https://doi.org/10.1589/jpts.26.741][Moon Y., Bae Y. The effect of backward walking observational training on gait parameters and balance in chronic stroke: randomized controlled study. European Journal of Physical and Rehabilitation Medicine; 2022; 58(1): 9–15. https://doi.org/10.23736/S1973-9087.21.06869-6][Chang K.W., Lin C.M., Yen C.W., et al. The Effect of Walking Backward on a Treadmill on Balance, Speed of Walking and Cardiopulmonary Fitness for Patients with Chronic Stroke: A Pilot Study. International Journal of Environmental Research and Public Health. 2021; 18(5): 2376. https://doi.org/10.3390/ijerph18052376][Shen M., Che S., Ye D., et al. Effects of backward walking on knee proprioception after ACL reconstruction. Physiotherapy Theory and Practice. 2021; 37(10): 1109–1116. https://doi.org/10.1080/09593985.2019.1681040][Uthoff A., Oliver J., Cronin J., et al. New Direction to Athletic Performance: Understanding the Acute and Longitudinal Responses to Backward Running. Sports Medicine. 2018; 48(5): 1083–1096. https://doi.org/10.1007/s40279-018-0877-5][Brosseau L., Taki J., Desjardins B., et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part three: aerobic exercise programs. Clinical Rehabilitation. 2017; 31(5): 612–624. https://doi.org/10.1177/0269215517691085][Thomas K.S., Hammond M., Magal M. Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait and Posture. 2018; (65): 20–25. https://doi.org/10.1016/j.gaitpost.2018.06.168][Gondhalekar G.A., Deo M.V. Retrowalking as an adjunct to conventional treatment versus conventional treatment alone on pain and disability in patients with acute exacerbation of chronic knee osteoarthritis: a randomized clinical trial. North American Journal of Medicine and Science. 2013; (5): 108–112. https://doi.org/10.4103/1947-2714.107527][Rathi M., Palekar T., Varghese A. Efficacy of backward walking on patients with osteoarthritis of knee on quadriceps strength, pain and physical functions. Indian Journal of Physiotherapy and Occupational Therapy. 2014; (8): 192–196. https://doi.org/10.5958/0973-5674.2014.00036.7][Wadhwa D.N., Hande D.N. Effects of retro walking on osteoarthritis of knee in geriatric population. IOSR Journal of Sports and Physical Education. 2016; (3): 37–43.][Manisha N., Joginder Y., Priyanka R. Effect of retro walking on pain, balance and functional performance in osteoarthritis of knee. Indian Journal of Physiotherapy and Occupational Therapy. 2015; (9): 154.][Khyatee, Mittal K., Gupta S.K. Retro treadmill walking as a rehabilitative tool in knee pain and quadriceps insufficiency. International Journal of Research in Science and Technology. 2013; 2(4): 1–8.][Anadkat H., Ajith S., Dhanesh Kumar K.U. Effectiveness of retro walking treadmill training on pain and disability in knee osteoarthritis: a randomized controlled trail. International Journal of Pharma and Bio Sciences. 2015; (6): 43–50.][Alghadir A.H., Anwer S., Sarkar B., et al. 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). BMC Musculoskelet Disord. 2019; 20(1): 159. https://doi.org/10.1186/s12891-019-2537-9][Shabbir S., Hashim M., Sajjad R., et al. Effects of Retro-Walking on Pain, Functional Disability and Performance in Knee Osteoarthritis. Pakistan Journal of Medical & Health Sciences. 2022; 16(2): 38–41. https://doi.org/10.53350/pjmhs2216238][Rangey P., Sheth M., Vyas N. Comparison of effectiveness of forward and backward walking on pain, physical function, and quality of life in subjects with osteoarthritis of knee. International Journal of Health and Allied Sciences. 2016; (5): 220.][Goonasegaran A.R., Suhaimi A., Mokhtar A.H. A randomized control trial on retro-walking improves symptoms, pain, and function in primary knee osteoarthritis. The Journal of Sports Medicine and Physical Fitness. 2022; 62(2): 229–237. https://doi.org/10.23736/S0022-4707.20.11686-4][Balasukumaran T., Olivier B., Ntsiea M.V. The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation. 2019; 33(2): 171–182. https://doi.org/10.1177/0269215518801430][Jansen K., Groote F.D., Massaad F., et al. Similar muscles contribute to horizontal and vertical acceleration of center of mass in forward and backward walking: implications for neural control. Journal of Neurophysiol. 2012; 107(12): 3385–3396. https://doi.org/10.1152/jn.01156.2011][Homma H., Suzuki H., Suzuki M., et al. Muscle activity of backward walking. Rigakuryoho Kagaku. 2013; 28(3): 323–328. https://clck.ru/3AjDQG][Chen Z., Ye X., Wang Y., et al. The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial. Complementary and Alternative Therapies for Pain Management. 2021: 5574966. https://doi.org/10.1155/2021/5574966][Enomoto H., Fujikoshi S., Ogawa K., et al. Relationship Between Pain Reduction and improvement in Health-Related Quality of Life in Patients with Knee Pain Due to Osteoarthritis Receiving Duloxetine: Exploratory Post Hoc Analysis of a Japanese Phase 3 Randomized Study. Journal of Pain Research. 2020; (13): 181–191. https://doi.org/10.2147/JPR.S211072][Almutairi S.M., Almutairi M.K., Alotaibi M.M., et al. Effects of backward walking exercise using lower body positive pressure treadmill on knee symptoms and physical function in individuals with knee osteoarthritis: a protocol for RCT. Journal of Orthopaedic Surgery and Research 2023; (18): 264. https://doi.org/10.1186/s13018-023-03711-x]