THE EFFECTS OF FORWARD WALKING VERSUS BACKWARD WALKING ON PAIN LEVEL, STATIC AND DYNAMIC BALANCE AMONG COLLEGIATE ATHLETES WITH KNEE INJURIES
DOI:
https://doi.org/10.37268/mjphm/vol.26/no.1/art.3403Keywords:
Backward Walking, Collegiate athletes, Dynamic Balance, Forward Walking, Knee injury, Static BalanceAbstract
Knee injuries are prevalent among collegiate athletes, necessitating effective rehabilitation strategies to restore function and minimize pain. The study aimed to compare the effects of backward and forward walking on pain levels, static, and dynamic balance in collegiate athletes with knee injuries over a 4-week intervention. Twenty-four collegiate athletes with an age of (M=22.43; SD=1.63 years) and at least 2 months of knee injury participated in the study. They were equally divided into forward walking (Group A) and backward walking (Group B) and were required to walk 3 times a week, with each session lasting 10 minutes. The results revealed that within group, both interventions showed significant pain reduction (forward walking: -22.42%; backward walking: -20.04%), and improvements in standing stork test for balance (forward: 12.87%; backward: 14.31%), anterior dynamic balance (forward: 21.32%; backward: 25.71%), posteromedial dynamic balance (forward: 33.86%; backward: 16.51%), and posterolateral dynamic balance (forward: 22.24%; backward: 26.09%) (p < 0.05). However, no significant differences were found between groups (p > 0.05). The results indicate that both interventions are equally effective on improving pain levels and balance among athletes with knee injuries. However, clinicians should consider patient preferences or specific clinical factors when selecting intervention strategies.
References
Harput G. Kinesiology of the knee joint. In: Elsevier eBooks. 2020. p. 393–410. doi:10.1016/b978-0-12-812162-7.00022-9.
Zhang M, Chen Z, Li G, Mak AFT, Roberts VC. Knee joint biomechanics in physiological conditions and how pathologies can affect it: a systematic review. Appl Bionics Biomech. 2020; 2020:1–19. doi:10.1155/2020/7451683.
Jabbar MAJ, Chandran J, Yi Yuan O, Masilamani R. Prevalence of musculoskeletal injuries among taekwondo players in Malaysia. Malays J Public Health Med. 2021;21(2):382–393. doi:10.37268/mjphm/vol.21/no.2/art.1072.
Ahmad DJ, Reefi AN, Alzahrani TS, Aljethaily AA, Almansour AF, Aldaghmani MS, et al. Strategies for X-ray utilization in the evaluation of knee injuries. Int J Community Med Public Health. 2023;11(1):485–490. doi:10.18203/2394-6040.ijcmph20233943.
Dewig D, Boltz A, Moffit R, Rao N, Collins C, Chandran A. Epidemiology of anterior cruciate ligament tears in National Collegiate Athletic Association athletes: 2014/2015–2018/2019. Med Sci Sports Exerc. 2023; 56:29–36. doi:10.1249/mss.0000000000003281.
Dewig D, Chandran A, Boltz A, Robison H, Collins C, Blackburn T. Epidemiology of anterior cruciate ligament injuries in National Collegiate Athletic Association athletes: 2014/15–2018/19. Med Sci Sports Exerc. 2022. doi:10.1249/01.mss.0000883056.32529.7d.
Marmura H, Bryant D, Getgood A. Sex differences and ACL injuries. Br J Sports Med. 2021; 55:1313–1314. doi:10.1136/bjsports-2021-104134.
Mavrovouniotis A, Potoupnis M, Sayegh F, Galanis N, Argiriadou E, Mavrovouniotis F. The effects of exercise on the rehabilitation of knee ligament injuries in athletes. Eur J Phys Educ Sport Sci. 2019; 5:2019–2019. doi:10.46827/EJPE.V0I0.2599.
He X. Observation on the rehabilitation effect of athletes with anterior cruciate ligament injury of the knee based on multidisciplinary combined nondrug therapy. J Healthc Eng. 2022; 2022:1–5. doi:10.1155/2022/9528354.
Cha H, Kim T, Kim M. Therapeutic efficacy of walking backward and forward on a slope in normal adults. J Phys Ther Sci. 2016;28(6):1901–1903. doi:10.1589/jpts.28.1901.
Alghadir AH, Anwer S, Sarkar B, Paul AK, Anwar D. 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. BMC Musculoskelet Disord. 2019;20(1). doi:10.1186/s12891-019-2537-9.
Parikh P, Desai D. Effectiveness of forward walking versus retro walking on balance, gait speed and lower body functional strength among the elderly population: a comparative study. Int J Health Sci Res. 2022. doi:10.52403/ijhsr.20220433.
Lam KC, Thomas SS, Valier ARS, McLeod TCV, Bay RC. Previous knee injury and health-related quality of life in collegiate athletes. J Athl Train. 2017;52(6):534–540. doi:10.4085/1062-6050-50.5.01.
Kay M, Register-Mihalik J, Gray A, Djoko A, Dompier T, Kerr Z. The epidemiology of severe injuries sustained by National Collegiate Athletic Association student-athletes, 2009–2010 through 2014–2015. J Athl Train. 2017;52(2):117–128. doi:10.4085/1062-6050-52.1.01.
Hao J, Pu Y, He Z, Remis A, Yao Z, Li Y. Measurement properties of the backward walk test in people with balance and mobility deficits: a systematic review. Gait Posture. 2024; 110:1–9. doi:10.1016/j.gaitpost.2024.02.018.
Wu Y, Lei C, Huangfu Z, Sunzi K, Yang C. Effect of backward walking training on knee osteoarthritis: protocol of a systematic review and meta-analysis. BMJ Open. 2020;10(10):e040726. doi:10.1136/bmjopen-2020-040726.
Dar SM, Nur Syuhada Mohd Faudzy. Habits Of Donning Headscarf: Correlation Between Neck Range of Motion and Proprioception Among Female Students of IIUM Kuantan Campus, Malaysia. MJPHM [Internet]. 2024 Dec. 28 ;24(3):63-70. Available from: https://mjphm.org/index.php/mjphm/article/view/2632.
Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021;18. doi:10.3352/jeehp.2021.18.17.
Bijur P, Silver W, Gallagher E. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153–1157. doi:10.1111/j.1553-2712.2001.tb01132.x.
Panta K, Arulsingh W, Raj JO, Sinha M, Rahman M. A study to associate the Flamingo Test and the Stork Test in measuring static balance on healthy adults. Foot Ankle Online J. 2015;8(3):4. doi: 10.3827/faoj.2015.0803.0004.
Takahashi H, Igawa T, Ito S, Urata R, Suzuki K, Ito R, et al. An examination of the intra-rater reliability of the Y Balance test for high school female athletes. J Phys Ther Sci. 2025; 37:1–5. doi:10.1589/jpts.37.1.
Sedhom MG. Backward walking training improves knee proprioception in non-athletic males. Int J Physiother. 2017;4(1). doi:10.15621/ijphy/2017/v4i1/136161.
Chen Z, Ye X, Wang Y, Shen Z, Wu J, Chen W, et al. The efficacy of backward walking on static stability, proprioception, pain, and physical function of patients with knee osteoarthritis: a randomized controlled trial. Evid Based Complement Alternat Med. 2021; 2021:1–9. doi:10.1155/2021/5574966.
Klemenov A. Possibilities with backward walking for knee pathology (literature review). Genij Ortopedii. 2021;27(1):128–131. doi:10.18019/1028-4427-2021-27-1-128-131.
Etefagh F, Jamshidi A, Nickjoo A. Walking backwards improves high school female athletes' balance. J Res Med Dent Sci. 2017; 5:46–48. doi:10.24896/JRMDS.V5I1.245.
Zhang M, Pang J, Lu J, Kang M, Chen B, Jones R, et al. The immediate effect of backward walking on external knee adduction moment in healthy individuals. J Healthc Eng. 2022;2022.doi:10.1155/2022/4232990.
Nurhanisah M, Sulaiman R, Khairul Manami, Che me R. A Survey on Musculoskeletal Pain and Discomfort Among Industrial Workers. MJPHM [Internet]. 2023 Dec. 28 ;23(3):235-44. Available from: https://mjphm.org/index.php/mjphm/article/view/1902.
Goonasegaran A, Suhaimi A, Mokhtar A. Retro-walking improves symptoms, pain, and function in primary knee osteoarthritis: a randomised control trial. J Sports Med Phys Fitness. 2020. doi:10.23736/S0022-4707.20.11686-4.
Zych M, Cannariato A, Bonato P, Severini G. Forward and backward walking share the same motor modules and locomotor adaptation strategies. Heliyon. 2021;7:e07864. doi:10.1016/j.heliyon.2021.e07864.