Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (26): 4251-4256.doi: 10.3969/j.issn.2095-4344.2770

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Effectiveness of backward walking training on knee osteoarthritis: a systematic review and meta-analysis

Chen Zehua1, Ye Xiangling1, Chen Weijian1, Xu Xuemeng1, 2   

  1. 1The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2The Second Chinese Medicine Hospital of Guangdong Province, Guangzhou 510405, Guangdong Province, China

  • Received:2019-11-08 Revised:2019-11-14 Accepted:2019-12-05 Online:2020-09-18 Published:2020-09-03
  • Contact: Xu Xuemeng, Professor, Chief physician, Doctoral supervisor, the Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; the Second Chinese Medicine Hospital of Guangdong Province, Guangzhou 510405, Guangdong Province, China
  • About author:Chen Zehua, MD candidate, Attending physician, the Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:
    Guangdong Province Famous Chinese Medicine Heritage Studio Construction Project, No. Guangdong Traditional Chinese Medicine Office Letter [2017]17; Guangdong Provincial Special Fund for Industrial and Information Development, No. Guangdong Finance and Industry [2016]69; National Administration of Traditional Chinese Medicine Key Specialized Construction Project, No. Guangdong Traditional Chinese Medicine [2012]7; Guangdong Natural Science Foundation-Doctor Launched, No. 2014A030310128; Breakthrough Projects of Superiority Diseases of Traditional Chinese Medicine in Guangdong Province, No. [2015]19; Guangdong Science and Technology Plan Project, No. 20191401

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Abstract:

BACKGROUND: Backward walking is mainly considered to improve the symptoms of patients with knee osteoarthritis, which is used for rehabilitation and adjuvant treatment of knee osteoarthritis, but there is no evidence for evidence-based medicine.

OBJECTIVE: To systematically review and quantify the evidence for the effect of backward walking on knee osteoarthritis in order to clarify the effect of backward walking on knee osteoarthritis.

METHODS: PubMed, CINAHL, EMBASE, CNKI, CBM, WanFang and VIP were searched for relevant literature. After randomized controlled trials were screened, a meta-analysis was used to evaluate the effectiveness of backward walking on knee osteoarthritis. A total of 7 articles involving 231 patients were included in the result analysis.

RESULTS AND CONCLUSION: Meta-analysis found that: compared with conventional treatment alone, the combination of conventional treatment with backward walking was better in pain relief [mean difference (MD)=-1.05, 95% confidence interval (CI) (-1.46, -0.63), P= 0.000 1], improving knee joint function [standardized mean difference (SMD)=-0.98, 95% CI (-1.33, -0.64), P < 0.000 01], enhancing quadriceps strength [SMD=1.07, 95% CI (0.52, 1.63), P=0.000 2] and improving timed up to go performance [MD=-0.41, 95% CI (-0.67, 0.16), P=0.001]. However, there was no significant difference in the WOMAC score after backward and forward walking [SMD=-0.43, 95% CI (-0.94, -0.08), P=0.10]. Meta-analysis results indicate that the combination of backward walking with conventional treatment has better clinical efficacy than conventional treatment alone for knee osteoarthritis patients. However, on the basis of conventional treatment, backward walking has comparable effects on WOMAC scores as compared with forward walking, which needs further large-sample high-quality randomized controlled trials to be verified.

Key words: backward walking, knee osteoarthritis, WOMAC, quadriceps strength, TUG test, meta-analysis

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