Efficacy of backward versus forward walking on hamstring strain rehabilitation

Objective: Hamstring muscle strain is one of the most frequently occurring injuries in sports. Backward Walking (BW) and Forward Walking (FW) on the treadmill are as a common tool for fitness training in the sports. However minimal clinical research has been conducted on the effectiveness of BW in addition to conservative hamstring strain rehabilitation. Materials and Methods: Thirty, grade I and II hamstring strain subjects with mean age of 25.19 ± 5.02 years were included in the study and, randomly assigned into two groups, BW and FW groups, (n=15) in each group and received 20 minutes of BW and FW respectively. All the participants in the both groups were treated with moist heat and followed by passive stretching. The total duration of the study was for three weeks and the treatment regime were administered four times a week for a total of 12 sessions. The study outcomes for pre and post treatment were measured before and after by lower extremity muscle strength, static and dynamic balance. Results: The results of the study indicate that determinants of quadriceps and ankle plantar flexors strength was significantly improved in the BW group (p<0.05) as compared with FW group and non-significant changes in hamstring strength for both groups (p>0.05). Although static balance improved significantly in BW group (p=0.000), whereas (p=.315) in FW group. Dynamic balance showed significant improvement in both groups (p<0.002). Conclusions: The results of the current study suggest that the static balance and muscle strength especially quadriceps and ankle plantar flexor were improved with BW. Study also concluded that the BW can be incorporated as a safe method of training during hamstring strain rehabilitation in addition to conservative management as there is less eccentric loading on hamstring muscle group during BW.