Effectiveness of backward walking exercises combined with conventional rehabilitation programs on managing pain intensity and disability in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.

Background: Knee osteoarthritis (OA) causes pain and diminishes quality of life. Backward walking exercise (BWE) has been shown to improve lower muscle strength and reduce knee adduction moment, making it a recommended intervention for knee OA rehabilitation. This study aims to evaluate the effectiv...

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Published in:Physiotherapy Theory & Practice Vol. 42; no. 1; pp. 217 - 232
Main Authors: Lin, Long-Huei, Peng, Yi-Ling, Yen, Ling-Wei, Tsai, Yun-Lin, Cheng, Chih-Hsiu
Format: meta analysis research systematic review tables/charts Journal Article
Published: Taylor & Francis Ltd Jan2026
Online Access:View this record in EBSCOhost
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      dt: Jan2026
      vid: 42
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      pub: Taylor & Francis Ltd
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        10.1080/09593985.2025.2550532
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        atl: Effectiveness of backward walking exercises combined with conventional rehabilitation programs on managing pain intensity and disability in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.
      aug:
        au:
          Lin, Long-Huei
          Peng, Yi-Ling
          Yen, Ling-Wei
          Tsai, Yun-Lin
          Cheng, Chih-Hsiu
        affil: School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
      sug:
        subj:
          Osteoarthritis, Knee Rehabilitation
          Therapeutic Exercise Methods
          Pain Prevention and Control
          Pain Management Methods
          Walking
          Functional Status
          Treatment Outcomes Evaluation
          Human
          Adult
          Middle Age
          Aged
          Systematic Review
          Meta Analysis
          PubMed
          Medline
          Physiotherapy Evidence Database
          Scales
          Visual Analog Scaling
          Publication Bias
          Walking Speed
          Treadmills
          Treatment Duration
          Severity of Disability
          Effect Size
          Confidence Intervals
          Regression
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
      ab: Background: Knee osteoarthritis (OA) causes pain and diminishes quality of life. Backward walking exercise (BWE) has been shown to improve lower muscle strength and reduce knee adduction moment, making it a recommended intervention for knee OA rehabilitation. This study aims to evaluate the effectiveness of BWE combined with conventional rehabilitation programs on pain intensity and disability among individuals with knee OA. Material and methods: Following the PRISMA guidelines, we systematically searched for studies from the inception to June 2025, prioritizing pain intensity as the primary outcome and disability as the secondary outcome, standardized by Hedges' g. A random-effects model was utilized for data pooling. Subgroup analyses focused on different walking speeds, surfaces, and control group characteristics. Results: Based on the final inclusion of 13 randomized controlled trials, combining BWE with conventional rehabilitation programs was found to significantly reduce pain intensity (Hedges' g = −0.997, 95% CI = −1.373 to −0.620) and improve disability (Hedges' g = −1.015, 95% CI = −1.326 to −0.703). Subgroup analyses revealed larger effect sizes for comfortable walking speed, and treadmill walking. Significant differences were observed across all control group comparisons (p <.05). Conclusion: BWE combined with rehabilitation showed moderate-to-large effect sizes in reducing pain and disability in knee OA. Future research should assess its standalone efficacy, long-term impact, and certainty of the evidence.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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