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)

Abstract Background Previous studies reported the beneficial effects of walking in individual with mild to moderate knee osteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps m...

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Main Authors: Ahmad H. Alghadir, Shahnawaz Anwer, Bibhuti Sarkar, Ashis K. Paul, Dilshad Anwar
Format: Article
Language:English
Published: BMC 2019-04-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-019-2537-9
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author Ahmad H. Alghadir
Shahnawaz Anwer
Bibhuti Sarkar
Ashis K. Paul
Dilshad Anwar
author_facet Ahmad H. Alghadir
Shahnawaz Anwer
Bibhuti Sarkar
Ashis K. Paul
Dilshad Anwar
author_sort Ahmad H. Alghadir
collection DOAJ
description Abstract Background Previous studies reported the beneficial effects of walking in individual with mild to moderate knee osteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps muscle strength and physical performance in individuals with knee OA. Methods A three-arm single-blinded, randomized, controlled trial and intention-to-treat analysis was conducted in outpatient physiotherapy department, King Saud University, Saudi Arabia. Sixty-eight individuals (mean age, 55.6 years; 38 female) with knee OA participated. The participants in the retro or forward walking group completed 10 min of supervised retro or forward walking training in addition to usual care, 3 days/week for 6 weeks. The control group received a routine physiotherapy program. This program comprises a combination of closed and open kinematic chain exercises, including straight leg raising, isometric quadriceps, isometric hip adduction, terminal knee extension, semi-squat, and leg press. The primary outcomes were mean pain and knee function score measured by the numerical rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index, respectively. The secondary outcomes were mean score of quadriceps muscle strength and timed up and go test scores. All the outcomes were analyzed at baseline and week 6. Results In total, 68 subjects participated in this 6-week randomized, controlled trial. The completion rates of the primary and secondary outcome measures at week 6 were 91, 87, and 82% in the retro walking, forward walking, and control groups, respectively. In the intention-to-treat analysis, the retro walking group had a greater reduction in pain intensity (mean changes, 1.8 versus 1; p = 0.01) and functional disability (mean changes, 4.8 versus 2.2; p = 0.008) than the control group. Similarly, the retro walking group had a greater improvement in the quadriceps muscle strength (mean changes, 1.7 kg versus 0.7 kg; p = 0.008) and the timed up and go test (mean changes, 0.6 s versus 0.1 s; p = 0.003) than the control group. Conclusions The 6-week retro walking program compared with forward walking or control groups resulted in greater reduction in pain and functional disability and improved quadriceps muscle strength and performance in individuals with knee OA. Trial registration Controlled Trials ISRCTN12850845, Registered 26 January 2015.
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spelling doaj.art-42b619f9e37041528c572bec7d174d042022-12-21T19:54:09ZengBMCBMC Musculoskeletal Disorders1471-24742019-04-0120111010.1186/s12891-019-2537-9Effect 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)Ahmad H. Alghadir0Shahnawaz Anwer1Bibhuti Sarkar2Ashis K. Paul3Dilshad Anwar4Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud UniversityRehabilitation Research Chair, College of Applied Medical Sciences, King Saud UniversityNational Institute for the Locomotor Disabilities (Divyangjan)Anand Vihar Hospital, Mahanadi Coalfields LimitedBone Joint and Trauma ClinicAbstract Background Previous studies reported the beneficial effects of walking in individual with mild to moderate knee osteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps muscle strength and physical performance in individuals with knee OA. Methods A three-arm single-blinded, randomized, controlled trial and intention-to-treat analysis was conducted in outpatient physiotherapy department, King Saud University, Saudi Arabia. Sixty-eight individuals (mean age, 55.6 years; 38 female) with knee OA participated. The participants in the retro or forward walking group completed 10 min of supervised retro or forward walking training in addition to usual care, 3 days/week for 6 weeks. The control group received a routine physiotherapy program. This program comprises a combination of closed and open kinematic chain exercises, including straight leg raising, isometric quadriceps, isometric hip adduction, terminal knee extension, semi-squat, and leg press. The primary outcomes were mean pain and knee function score measured by the numerical rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index, respectively. The secondary outcomes were mean score of quadriceps muscle strength and timed up and go test scores. All the outcomes were analyzed at baseline and week 6. Results In total, 68 subjects participated in this 6-week randomized, controlled trial. The completion rates of the primary and secondary outcome measures at week 6 were 91, 87, and 82% in the retro walking, forward walking, and control groups, respectively. In the intention-to-treat analysis, the retro walking group had a greater reduction in pain intensity (mean changes, 1.8 versus 1; p = 0.01) and functional disability (mean changes, 4.8 versus 2.2; p = 0.008) than the control group. Similarly, the retro walking group had a greater improvement in the quadriceps muscle strength (mean changes, 1.7 kg versus 0.7 kg; p = 0.008) and the timed up and go test (mean changes, 0.6 s versus 0.1 s; p = 0.003) than the control group. Conclusions The 6-week retro walking program compared with forward walking or control groups resulted in greater reduction in pain and functional disability and improved quadriceps muscle strength and performance in individuals with knee OA. Trial registration Controlled Trials ISRCTN12850845, Registered 26 January 2015.http://link.springer.com/article/10.1186/s12891-019-2537-9Knee osteoarthritisWalkingExerciseRetro walkingMuscle strength
spellingShingle Ahmad H. Alghadir
Shahnawaz Anwer
Bibhuti Sarkar
Ashis K. Paul
Dilshad Anwar
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 Musculoskeletal Disorders
Knee osteoarthritis
Walking
Exercise
Retro walking
Muscle strength
title 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)
title_full 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)
title_fullStr 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)
title_full_unstemmed 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)
title_short 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)
title_sort 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
topic Knee osteoarthritis
Walking
Exercise
Retro walking
Muscle strength
url http://link.springer.com/article/10.1186/s12891-019-2537-9
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