Effect of backward walking training on foot posture and balance in flat foot adults

Introduction
Flat foot changes the posture of the foot and affects dynamic balance. Backward walking is a novelty in rehabilitative clinic; it improves strength and balance. The aim of this study was to investigate the effect of backward walking training on foot posture and dynamic balance in flat foot subjects.

Methods
Overall, 44 participants with bilateral mobile flat foot, aged 19–35 years, were randomly assigned to 2 equal groups. Group A received backward walking training 3 times/week for 6 weeks, in addition to traditional physical therapy exercises. Group B received traditional physical therapy exercises only, 3 times/week for 6 weeks. Before and after treatment, foot posture was assessed with the Foot Posture Index and balance was evaluated with the HUMAC Balance System through the Limits of Stability test.

Results
Statistical analysis revealed a significant reduction in the Foot Posture Index and a significant increase of the Limits of Stability in both groups after treatment compared with the pre-treatment status (p < 0.001). Comparison between the groups after treatment showed a significant decrease in the Foot Posture Index in group A compared with group B (p < 0.05) and a significant increase in the Limits of Stability in group A compared with group B (p < 0.001).

Conclusions
Backward walking training as an addition to physical therapy exercises of flat foot can improve foot posture and enhance balance in comparison with physical therapy exercises alone.