Comparison of effectiveness of forward and backward walking on pain, physical function, and quality of life in subjects with osteoarthritis of knee

Abstract

Context: Walking, both forward and backward, is found to be effective for reducing pain in subjects with osteoarthritis (OA) of the knee and improving physical function and quality of life (QOL). Aims: This study aims to determine and compare the effects of forward walking (FW) and backward walking (BW) on pain, physical function, and QOL in subjects with OA knee. Settings and Design: Quasi-experimental study set up at general hospital, Ahmedabad, India. Subjects and Methods: Thirty subjects >40 years diagnosed as having bilateral OA knee according to American College of Rheumatology criteria having indoor and outdoor walking ability without aids were included in this study. Group A and B subjects received FW and BW respectively for 10 min in addition to conventional treatment thrice daily for 2 weeks. Group C received conventional treatment in the form of hot water fomentation and exercises. Exercises comprised of static quadriceps, short arc terminal extension of the knee, ankle toe movements, straight leg raises, knee flexion and extension, proprioceptive exercises in the form of lunges, weight shifts, partial squats and balance training on the balance board and stretching of hamstrings, tendo-Achilles and rectus femoris muscles. Statistical Analysis Used: SPSS 16.0 (IBM Corporation). Parametric tests were used. The level of significance was 5%. Results: The results showed improvement in all the outcome measures within all the three groups. However, there was no statistically significant difference between the groups except Western Ontario and McMaster Universities Arthritis Index (WOMAC). Visual analog scale (VAS) at rest on the right side in all three groups and on the left side in Group A as well as in scores of VAS at activity on both the sides (P 0.05). Improvement in WOMAC scores within all the 3 groups (P 0.05). Statistically significant difference between the groups for WOMAC (P = 0.043), Group A was better than Group C (P = 0.043). Conclusions: FW and BW along with conventional therapy are equally effective and not better than conventional treatment alone in reducing pain and improving physical function and QOL.