Skip to main content
Log in

Movement Analysis of Lower Limb During Backward Walking with Unstable Intervention

  • Original Article
  • Published:
Journal of Medical and Biological Engineering Aims and scope Submit manuscript

Abstract

Backward walking (BW), an emerging rehabilitative and training modality, was integrated with unstable sole construction with various hardness levels to analyze the kinematic and kinetic characteristics of the lower extremities. Eighteen participants volunteered to participate in the test. They performed walking tests under three conditions: (1) BW with normal shoes (NBW); (2) BW with unstable shoes with soft unstable elements (UBW-S); (3) BW with unstable shoes with hard unstable elements (UBW-H). The results show increased hip and ankle flexion and increased knee flexion–extension extent in the stance phase during BW with unstable shoes. The motor control mechanism of unstable BW enhanced the rehabilitation of lower limb deficiency. The attached unstable elements (UBW-S and UBW-H) induced local perturbation to stimulate proprioceptive ability and the neuromuscular system, changing the plantar loading distribution in a certain region. Future study should concentrate on the possible rehabilitative effect of unstable BW on neurological disorders and motor system deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lee, M., Kim, K., Son, J., & Kim, Y. (2013). Kinematic and kinetic analysis during forward and backward walking. Gait & Posture, 38(4), 674–678.

    Article  Google Scholar 

  2. Armstrong, C. W., Commager, J. M., and Woolley, S. (1989) “A comparative analysis of forward and backward walking”. In: Proceedings of the 6th annual East Coast clinical gait conference, Lansing, MI, vol. 989, pp. 98–70.

  3. Thorstensson, A. (1986). How is the normal locomotor program modified to produce backward walking? Experimental Brain Research, 61(3), 664–668.

    Article  Google Scholar 

  4. Van Deursen, R. W. M., Flynn, T. W., McCrory, J. L., & Morag, E. (1998). Does a single control mechanism exist for both forward and backward walking? Gait & Posture, 7(3), 214–224.

    Article  Google Scholar 

  5. Yang, Y. R., Yen, J. G., Wang, R. Y., Yen, L. L., & Lieu, F. K. (2005). Gait outcomes after additional backward walking training in patients with stroke: A randomized controlled trial. Clinical Rehabilitation, 19(3), 264–273.

    Article  Google Scholar 

  6. Itoh, C., Kasai, T., & Wakayama, S. (2015). Comparison of forward and backward walking in gait initiation. Physiotherapy, 101(1), e660.

    Google Scholar 

  7. Rose, D. K., & DeMark, L. (2013). Backward walking training to improve mobility in acute stroke: A pilot study. Archives of Physical Medicine and Rehabilitation, 94(10), 36.

    Article  Google Scholar 

  8. Kramer, J. F., & Reid, D. C. (1981). Backward walking: A cinematographic and electromyographic pilot study. Physiother, 33(2), 77–86.

    Google Scholar 

  9. Huang, H., Chen, C., Chang, J., Guo, L., Lin, H., & Wu, W. (2008). Quantitative gait analysis after unilateral knee arthroplasty for patients with bilateral knee osteoarthritis. Journal of Medical and Biological Engineering, 28(1), 11–16.

    Google Scholar 

  10. Mackie, J. W., & Dean, T. E. (1984). Running backward training effects on upper leg musculature and ligamentous instability of injured knees. Medicine and Science in Sports and Exercise, 16(2), 151.

    Article  Google Scholar 

  11. Thelkeld, A. J., Horn, T. S., Wojtowicz, G. M., Rooney, J. G., & Shapiro, R. (1989). Kinematics, ground reaction force, and muscle balance produced by backward running. Journal of Orthopaedic and Sports Physical Therapy, 11(2), 56–63.

    Article  Google Scholar 

  12. Zhang, X., Zhang, Y., Gao, X., Wu, J., Jiao, X., Zhao, J., et al. (2014). Investigating the role of backward walking therapy in alleviating plantar pressure of patients with diabetic peripheral neuropathy. Archives of Physical Medicine and Rehabilitation, 95(5), 832–839.

    Article  Google Scholar 

  13. Fitzgerald, G. K., Childs, J. D., & Ridge, T. M. (2002). Agility and perturbation training for a physically active individual with knee osteoarthritis. Physical Therapy, 82(4), 372–382.

    Google Scholar 

  14. Vilensky, J. A., Gankiewicz, E., & Gehlsen, G. (1987). Kinematic comparison of backward and forward walking in humans. Journal of Human Movement Studies, 13, 29–50.

    Google Scholar 

  15. Muddasir, A., & Nanda, K. T. R. (2009). The effect of backward walking treadmill training on kinematics of the trunk and lower limbs. Serbian Journal of Sports Sciences, 3, 121–127.

    Google Scholar 

  16. Kutzner, I., Stephan, D., Dymke, J., Bender, A., Graichen, F., & Bergmann, G. (2013). The influence of footwear on knee joint loading during walking-in vivo load measurements with instrumented knee implants. Journal of Biomechanics, 46(4), 796–800.

    Article  Google Scholar 

  17. Gu, Y., Lu, Y., Mei, Q., Li, J., & Ren, J. (2014). Effects of different unstable sole construction on kinematics and muscle activity of lower limb. Human Movement Science, 36, 46–57.

    Article  Google Scholar 

  18. Amir, H., Nimrod, R., & Alon, W. (2010). The influence of sagittal center of pressure offset on gait kinematics and kinetics. Journal of Biomechanics, 43, 969–977.

    Article  Google Scholar 

  19. Chang, L., Su, F., Lai, K., & Tsai, K. (2005). Gait analysis after shoe lifts in adults with unilateral developmental dysplasia of the hip. Journal of Medical and Biological Engineering, 25(3), 137–141.

    Google Scholar 

  20. Nigg, B. (2009). Biomechanical considerations on barefoot movement and barefoot shoe concepts. Footwear Science, 1, 73–79.

    Article  Google Scholar 

  21. Stöggl, T., Haudum, A., Birklbauer, J., Murrer, M., & Müller, E. (2010). “Short and long term adaptation of variability during walking using unstable (Mbt) shoes”. Clinical Biomechanics, 25, 816–822.

    Article  Google Scholar 

  22. Turbanski, S., Lohrer, H., Nauck, T., & Schmidtbleicher, D. (2011). Training effects of two different unstable shoe constructions on postural control in static and dynamic testing situations. Physical Therapy in Sport, 12, 80–86.

    Article  Google Scholar 

  23. Grasso, R., Bianchi, L., & Lacquaniti, F. (1998). Motor patterns for human gait: Backward versus forward locomotion. Journal of Neurophysiology, 80, 1868–1885.

    Google Scholar 

  24. Papalia, R., Di Pino, G., Tecame, A., Vadala`, G., Formica, D., Di Martino, A., et al. (2015). “Biomechanical and neural changes evaluation induced by prolonged use of non-stable footwear: A systematic review”. Musculoskeletal Surgery, 11, 1–5.

    Google Scholar 

  25. Van Engelen, S., Wajer, Q. E., & Van der Plaat, L. W. (2010). Metabolic cost and mechanical work during walking after tibiotalar arthrodesis and the influence of footwear. Clinical Biomechanics, 25(8), 809–815.

    Article  Google Scholar 

  26. Nigg, B. M., Emery, C., & Hiemstra, L. A. (2006). Unstable shoe construction and reduction of pain in osteoarthritis patients. Medicine and Science in Sports and Exercise, 38(10), 1701–1708.

    Article  Google Scholar 

  27. Mei, Q., Feng, N., Ren, X., Lake, M., & Gu, Y. (2015). Foot loading patterns with different unstable soles structure. Journal of Mechanics in Medicine and Biology, 15(1), 1550014.

    Article  Google Scholar 

  28. Li, F., Mei, Q., & Gu, Y. (2015). Effects of unstable elements with different hardness on lower limb loading. Acta of Bioengineering and Biomechanics, 17(2), 85–92.

    Article  Google Scholar 

  29. Debbi, E. M., Wolf, A., & Haim, A. (2012). Detecting and quantifying global instability during a dynamic task using kinetic and kinematic gait parameters. Journal of Biomechanics, 45(8), 1366–1371.

    Article  Google Scholar 

  30. Brian, H., & Arnold, B. (2013). Effects of toning shoes on lower extremity gait biomechanics. Clinical Biomechanics, 28(3), 344–349.

    Article  Google Scholar 

  31. Nigg, B., Hintzen, S., & Ferber, R. (2006). Effect of an unstable shoe construction on lower extremity gait characteristics. Clinical Biomechanics, 21(1), 82–88.

    Article  Google Scholar 

  32. Zhang, M., Liu, A., & Jiang, L. (2015). The biomechanical effects of backward walking on the knee: A new method for releasing the joint loading. Osteoarthritis and Cartilage, 23, A121–A122.

    Article  MathSciNet  Google Scholar 

  33. Dufek, J., House, A., & Mangus, B. (2011). Backward walking: A possible active exercise for low back pain reduction and enhanced function in athletes. Journal of Exercise Physiology, 14, 17–26.

    Google Scholar 

  34. Poosapadi Arjunan, S., Kumar, D., Poon, W., Rudolph, H., & Hu, Y. (2010). Variability in surface electromyogram during gait analysis of low back pain patients. Journal of Medical and Biological Engineering, 30(3), 133–138.

    Google Scholar 

  35. Flynn, T. W., & Soutas-Little, R. W. (1995). Patellofemoral joint compressive forces in forward and backward running. Journal of Orthopaedic and Sports Physical Therapy, 21(5), 277–282.

    Article  Google Scholar 

  36. Stewart, L., Gibson, J. N. A., & Thomson, C. E. (2007). In-shoe pressure distribution in “unstable” (MBT) shoes and flat-bottomed training shoes: A comparative study. Gait & Posture, 26(4), 648–651.

    Article  Google Scholar 

Download references

Acknowledgments

This study sponsored by Zhejiang Social Science Program ‘Zhi Jiang youth project’ (16ZJQN021YB), National Natural Science Foundation of China (81301600), K. C. Wong Magna Fund in Ningbo University, National Social Science Foundation of China (16BTY085), and Anta Sports Products Limited.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yaodong Gu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shu, Y., Gu, Y., Mei, Q. et al. Movement Analysis of Lower Limb During Backward Walking with Unstable Intervention. J. Med. Biol. Eng. 36, 718–725 (2016). https://doi.org/10.1007/s40846-016-0166-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40846-016-0166-4

Keywords

Navigation