title: Effect of retro and forward walking on quadriceps muscle strength, pain, function, and mobility in patients with knee osteoarthritis: a protocol for a randomized controlled trial.
abstract: BACKGROUND
  Walking, a closed kinetic chain (CKC) activity, is widely used in knee rehabilitation as it allows early weight bearing and movement. It has been suggested that retro-walking may provide additional benefits beyond those experienced by forward-walking. The present study will investigate the effect of retro- and forward-walking on quadriceps muscle strength, pain, function, balance and mobility in knee Osteoarthritis (OA) subjects.
  
  
  METHODS
  Sixty-nine participants with knee OA will be recruited from the outpatient department in this randomized controlled trial. The participants will be randomly assigned to one of three groups; retro walking, forward walking or control group. The training program will be 3 days/week for 6 weeks. In addition, all the participants will receive a standard physiotherapy training program. An independent assessor blinded to group assignment will measure quadriceps muscle strength, knee pain intensity, functional disability, and mobility at baseline and 6 weeks after training.
  
  
  CONCLUSIONS
  The results of this study will enhance our understanding on the therapeutic effects of walking (retro- or forward-walking) in knee OA. The findings from this study will help determine whether retro- or forward-walking or both are effective in the rehabilitation of subjects with knee OA.
  
  
  BACKGROUND
  Controlled Trials ISRCTN12850845, Registered 26 January 2015.
authors.affiliation: Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O.Box-10219, Riyadh, Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alghadir
authors.affiliation: Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O.Box-10219, Riyadh, Saudi Arabia. anwer_shahnawazphysio@rediffmail.com.|Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India. anwer_shahnawazphysio@rediffmail.com.
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Anwer
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D052097:Quadriceps Muscle / Q000502:physiology*; D016037:Single-Blind Method; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: Exercise; Knee; Osteoarthritis; Walking