Gait & Posture 38 (2013) 674–678

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Gait & Posture

journal homepage: www.elsevier.com/locate/gaitpost

Kinematic and kinetic analysis during forward and backward walking

Minhyeon Lee, Jungyoon Kim, Jongsang Son, Youngho Kim *
Department of Biomedical Engineering, Yonsei University, Room 204, Medical Industry Techno Tower, Heungup, Wonju, Gangwon 220-710, South Korea

A R T I C L E I N F O A B S T R A C T

Article history: Backward walking (BW) is a recently emerging exercise. However, limited studies exist regarding the
Received 13 June 2011 motion analysis of BW compared with that of forward walking (FW). The present study identified the
Received in revised form 31 January 2013 mechanisms of BW through kinetic analysis and focused on BW time-reversed data. A three-dimensional
Accepted 24 February 2013
motion capture system was used to acquire the joint movements and to calculate the joint moments and
the powers during walking. Ground reaction force curves were acquired from force plates. Each
Keywords: participant performed 10 FW trials and 40 BW trials with bare feet. All data were analyzed using paired t-
Backward walking
tests (p < 0.05) to verify the significant differences between FW and BW. In BW, since the progress is in
Normal gait
Human locomotion
the direction in which the person cannot see, the walker’s speed is generally decreased compared to FW.
Gait analysis As a result, the stride characteristics for each respective activity showed significant differences. The
Motion capture characteristics of angular displacement in all joints were almost identical in FW and time-reversed BW.
However, selected crucial points of joint angles were significantly different. The moment pattern of the
ankle joint was very similar in FW and time-reversed BW. In the knee and the hip joint, the joint moment
pattern of time-reversed BW was simpler than FW. The joint power patterns of the ankle, the knee and
the hip were different in FW and BW. An original finding of this study was that the main propulsion and
shock absorption joint during BW is the ankle joint. The knee and hip joint did not generate propulsion
power.
ß 2013 Elsevier B.V. All rights reserved.

1. Introduction Adopting the motor/system control perspective, research in

Backward walking (BW) is a recently emerging exercise that
helps enhance the balance and muscle strength of the lower
limbs [1–6]. BW provides a stronger musculoskeletal system and
cardiovascular function [1]. BW is also beneficial to patients
with overuse injuries in the lower extremities since lower
patellofemoral joint reaction forces were observed in BW
compared to forward walking (FW) [2]. This activity is
recommended for hemiplegic patients to realize or improve
proper motor control and gait performance [3]. Yang et al. [4]
demonstrated that asymmetric gait patterns of post-stroke
patients could be improved after receiving BW therapy. Hackney
and Earhart [5] reported BW’s efficacy in improving functional
mobility, gait performance and balance of patients with
Parkinson’s disease.
* Corresponding author. Tel.: +82 33 760 2859; fax: +82 33 760 2806.
E-mail addresses: minhyeon@yonsei.ac.kr (M. Lee), astasdf@gmail.com
(J. Kim), jongsang.son@yonsei.ac.kr (J. Son),
younghokim@yonsei.ac.kr (Y. Kim).
human walking has classified the aforementioned retro-locomo-
tion as a type of ‘‘reversible movement’’. Researchers have asserted
that the joint motions of FW, especially at the hip and ankle, are
similar to the time-reversed counterpart of BW [6–9]. However,
researchers differ in their statements on muscle activation during
BW. Thorstensson [7] reported that electromyelography (EMG)
patterns of muscle activity in BW show a poor relation to those in
FW. Grasso et al. [8] found that the difference was the origin of
propulsion by EMG analysis; while the main FW propulsion is
generated by the ankle plantarflexors, the principal BW propulsion
is provided by the hip and knee extensors.
Limited studies exist regarding the motion analysis of BW
compared with that of FW. Though some kinematic analyses of BW
have been made, the lack of research on BW lies prominently in its
kinetic analysis. BW is an instinct of human locomotion based on
FW, so studies in BW have substantial potential for understanding
the control of human locomotive behavior [10].
The present study identified the mechanisms of BW through
kinetic analysis and concentrated on BW time-reversed data.
It focused on comparing the spatiotemporal parameters and
time-reversed data of BW kinematics and kinetics to those of
non-reversed FW, and the results should contribute to the
understanding of the mechanism of gait during BW.

0966-6362/$ – see front matter ß 2013 Elsevier B.V. All rights reserved.
http://dx.doi.org/10.1016/j.gaitpost.2013.02.014
 M. Lee et al. / Gait & Posture 38 (2013) 674–678
2. Methods
2.1. Participants
Thirty-one healthy subjects 22.4  3.2 years of age,
171.5  5.5 cm in height, and weighing 70.0  10.4 kg participated
in this study. These twenty-six male and five female participants had
no evidence or history of lower-limb diseases nor any record of
surgery to the lower limbs. All participants gave informed consent
before taking part in the experiments.
2.2. Instrumentation
A three-dimensional motion capture system (VICON 612,
VICON Motion Systems, Oxford, UK) was used to acquire joint
movements and to calculate joint moments and power during
walking using inverse dynamics. Calibration of the system was
performed before the gait trials. Sixteen retro-reflective markers
(14 mm in diameter) were attached with double-sided tape to the
participants’ lower limbs according to the Plug-In-Gait marker set.
Motion data were collected at 120 samples per second. All marker
coordinates were smoothed with a Woltring filter (MSE = 15).
Ground reaction force (GRF) curves were acquired from two
Kistler (5233A2, Kistler, Winterthur, Switzerland) and two AMTI
(OR6-6, AMTI, Watertown, US) force plates. The GRF data were
sampled at 1080 Hz. The marker and force data were time-
synchronized.
2.3. Procedures
Before the gait analysis, the participants’ age, height, weight,
and lower-extremity anthropometric data were measured. Each
participant performed 10 FW trials and 40 BW trials on a 10-m
walkway with bare feet. For the trials, stride characteristics,
marker coordinates, and GRFs were recorded simultaneously. The
participants practiced BW prior to the actual experiments for
successful adaptation to the new environment and walking
pattern. To reflect their natural stride length and unique gait
characteristics, participants were required to walk at a comfortable
pace without an awareness of the position of the force plates.
2.4. Data analysis
Data pairs acquired from the markers and force plates were
used to calculate joint angles, moments, and powers through the
Plug-In-Gait Biomechanical Modeler Pipeline (Oxford Metrics,
Oxford, UK). Spatiotemporal parameters were computed from the
marker coordinate data using a developed code (MATLAB, Math-
Works Inc., US).
The gait patterns of BW were divided into the following: (1) toe-
contact to heel-off pattern (heel-off) and (2) toe-contact to toe-off
pattern (toe-off). The toe-off pattern often was evident in the early
trials of the experiments. The moment and power data of the toe-
off pattern were smaller than those of the heel-off pattern. The toe-
off pattern resulted from a lack of training, so these data were
excluded. FW consists of heel contact to toe off, which means that
FW and BW (heel off) had opposite contact positions (toe or heel)
for the same event (contact or push off). To adhere to the purpose
of this study, which was to compare the kinematic and kinetic
patterns of FW and BW, joint angle curves and joint moments for
BW (heel off) were time-reversed to equalize the contact position
as well as the type of event. First, the whole stance phase was
reversed. Then, the remaining gait cycle (the swing phase) was
reversed to form an entirely new gait cycle with each phase
reversed. The GRF curves of BW were not time-reversed because
they are affected more by the participant’s body weight than
675
the gait event itself [11]. The power curves of BW also were not
time-reversed to describe BW’s mechanism. As referenced in
Benedetti et al. [12], crucial points among the joint angles,
moments, and power curves were chosen as gait parameters to
compare FW and BW.
Gait cycles were normalized entirely from 0% to 100% of the gait
cycle to clearly distinguish both major and minor variations in the
patterns of any individual trial [13]. Spatiotemporal parameters,
kinematics, kinetics, and GRF data were determined from each
participant during both forward and backward level walking.
Sagittal plane motions were analyzed as the majority of the forces
and motions occur in this plane [14].
2.5. Statistical analysis
The spatiotemporal parameters were also analyzed using
paired t-tests (p < 0.05) to verify the significant differences
between forward and backward walking. Paired t-tests
(p < 0.05) were used to detect significant differences in gait
parameters. All data were analyzed with the Statistical Package for
the Social Sciences (SPSS) 19 statistical software.
3. Results
3.1. Stride characteristics
Significant reductions in walking speed (1.3  0.1 m/s vs.
1.1  0.1 m/s, p < 0.05) and cadence (111.4  5.2 steps/min vs.
98.1  8.1 steps/min, p < 0.05) were observed in BW compared with
FW. However, no significant differences were found in the stance
phase percentage (60.1  1.4% gait cycle vs. 60.4  1.6% gait cycle,
p = 0.321). Stride time (1.1  0.1 s vs. 1.2  0.1 s, p < 0.05) increased
significantly during BW. Stride length was also significantly different
between BW and FW (1.4  0.1 m vs. 1.3  0.1 m, p < 0.05) (Table 1).
3.2. Kinematics
The characteristics of angular displacement in the ankle, knee
and hip were almost identical in FW and time-reversed BW (Fig. 1).
However, selected crucial points of joint angles were significantly
different (Table 2).
There was no significant difference in the maximum plantar-
flexion at the loading response during FW and pre-swing during
BW (A1, p = 0.335; Fig. 1a, Table 2). The ankle joint was
significantly dorsiflexed during the swing phase to loading
response in BW than pre-swing to the swing phase in FW (A2
and A3, p < 0.05; Fig. 1a, Table 2). The total range of motion (A4,
p < 0.05) was also significantly different.
The knee showed significant flexion at the loading response
during FW compared to pre-swing during BW (K1, p < 0.05; Fig. 1b,
Table 2). The knee was less flexed at the initial swing during FW
(K2, p < 0.05) than it was for the terminal swing during BW. The
total range of motion of the knee was greater in FW (K3, p < 0.05).
Table 1
Stride characteristics: forward walking vs. backward walking.
Stride characteristics Forward Backward p-value
walking walking
Mean  SD Mean  SD
Walking speed (m/s) 1.3  0.1 1.1  0.1 <0.001**
Cadence (steps/min) 111.4  5.2 98.1  8.1 <0.001**
Stance phase percentage 60.1  1.4 60.4  1.6 0.321
in gait cycle (%)
Stride time (s) 1.1  0.1 1.2  0.1 <0.001**
Stride length (m) 1.4  0.1 1.3  0.1 0.016*
*p < 0.05; **p < 0.01.
676 M. Lee et al. / Gait & Posture 38 (2013) 674–678
Fig. 1. Mean joint angles, moments, and powers of ankle, knee and hip during FW and BW. (a) Ankle joint, (b) knee joint, and (c) hip joint.
The hip showed significantly less flexed at the initial contact
during FW than the heel off during BW (H1, p < 0.05; Fig. 1c,
Table 2) and was less extended at the loading response of BW than
the pre-swing of FW (H2, p < 0.05; Fig. 1c, Table 2). The total range
of motion of the knee was greater in FW (H3, p < 0.05).
3.3. Kinetics
3.3.1. Joint moments
The characteristics of joint moment in the ankle were almost
identical in FW and time-reversed BW (Fig. 1a). In the knee and hip
joint, joint moment characteristics of time-reversed BW were
simpler than FW (Fig. 1b and c).
There was no significant difference in the maximum dorsi-
flexor moment of the ankle joint in the loading response phase
during FW and in the pre-swing phase during BW (AM1, p = 0.056;
Fig. 1a and Table 2). There was no significant difference in the
maximum plantarflexor moments during the stance phase (AM2,
p = 0.226).
No significant difference existed in the maximum extensor
moment of the knee joint in the loading response phase during
FW and the pre-swing phase during BW (KM1, p = 0.103; Fig. 1b
and Table 2). The maximum flexor moment in the stance phase
during FW was significantly larger than during BW (KM2,
p < 0.05).
The hip showed significantly larger extensor moment in the
stance phase during FW than it did during BW (HM1, p < 0.05;
Fig. 1c and Table 2). The maximum flexor moment in the stance
phase during FW was significantly larger than that observed during
BW (HM2, p < 0.05).
3.3.2. Joint powers
The characteristics of joint power in the ankle, knee and hip
were different in FW and BW (Fig. 1). The peak power generation,
absorption timing, and amplitude were different in the ankle joint,
while the numbers of peak power generation and absorption were
different in knee and hip joints.
In the ankle joint, the maximum power generation during FW
was significantly larger than during BW (AP1, p < 0.05; Fig. 1a,
Table 2). The maximum power absorption during FW was
significantly smaller than during BW (AP2, p < 0.05). There was
no significant difference in the maximum power generation for
the knee joint (KP1, p = 0.12; Fig. 1b and Table 2). The maximum
power absorption during BW for the knee joint was significantly
smaller than during FW (KP2, p < 0.05; Fig. 1b and Table 2). In
the hip joint, the maximum power generation at loading
response during FW was significantly larger than that observed
during BW (HP1, p < 0.05; Fig. 1c and Table 2). The maximum
power generation in the swing phase during FW was also
significantly larger than that produced during BW (HP2,
p < 0.05).
3.3.3. Ground reaction forces
The patterns of the vertical GRF curves also differed between
FW and BW (Fig. 2). The GRFs on both FW and BW exhibited two
main peaks during the loading response and pre-swing phase.
 M. Lee et al. / Gait & Posture 38 (2013) 674–678 677

Table 2
Comparison of joint angles and moments variables: forward walking vs. backward walking.

Forward walking Backward walking p-value

Mean  SD Mean  SD

Ankle variable
A1 Max. plantarflexion in loading response (pre swing in BW) (8) 4.0  2.4 4.1  3.5 0.335
A2 Max. dorsiflexion in stance (8) 14.8  2.3 17.9  2.0 <0.001**
A3 Max. plantarflexion in swing (8) 17.7  4.8 3.0  3.4 <0.001**
A4 Total range of motion (8) 32.5  4.0 21.4  3.3 <0.001**
AM1 Max. dorsiflexor moment (N m/kg) 0.15  0.07 0.24  0.08 0.056
AM2 Max. plantarflexor moment (N m/kg) 1.67  0.08 1.60  0.11 0.226
AP1 Max. power generation (W/kg) 4.42  0.38 1.25  0.18 <0.001**
AP2 Max. power absorption (W/kg) 0.9  0.2 2.9  0.6 <0.001**

Knee variable
K1 Max. flexion in loading response (pre swing in BW) (8) 14.6  2.2 12.4  4.7 <0.001**
K2 Max. flexion in swing (8) 59.6  3.3 45.7  8.4 <0.001**
K3 Total range of motion (8) 61.4  3.6 47.9  8.6 <0.001**
KM1 Max. extensor moment (N m/kg) 0.54  0.06 0.49  0.10 0.103
KM2 Max. flexor moment in stance (N m/kg) 0.38  0.11 0.01  0.09 <0.001**
KP1 Max. power generation (W/kg) 1.05  0.36 0.85  0.23 0.120
KP2 Max. power absorption in loading response (W/kg) 0.79  0.28 0.17  0.16 <0.001**

Hip variable
H1 Flexion at heel strike (heel off in BW) (8) 31.8  3.7 29.5  3.8 <0.001**
H2 Max. extension in stance (8) 12.3  3.9 6.8  4.8 <0.001**
H3 Total range of motion (8) 45.2  2.8 37.7  4.3 <0.001**
HM1 Max. extensor moment in stance (N m/kg) 0.50  0.19 0.12  0.07 <0.001**
HM2 Max. flexor moment in stance (N m/kg) 0.69  0.14 0.50  0.15 <0.001**
HP1 Max. power generation in loading response (W/kg) 0.69  0.13 0.54  0.21 <0.001**
HP2 Max. power generation in swing (W/kg) 1.33  0.17 0.14  0.07 <0.001**

*p < 0.05; **p < 0.01.

However, the first peak of BW was higher than FW, and the second
BW peak was smaller than that for FW.
4. Discussion
In BW, since the person cannot see the direction of the progress,
the speed generally decreased compared to FW. As a result, the
stride characteristics showed significant differences between FW
and BW [16]. However, unlike the differences in cadence and stride
length found in this study, previous researchers have noted only
slight differences in average speed between FW and BW [6,8].
Stride length differs significantly because the average range of
motion in the hip joint between flexion and extension varies
greatly; the flexion angle was 908, and the extension angle was 208
[15].
Our results compare favorably with previous reports [6–8]. The
angular displacement patterns in the ankle, the knee and the hip
were almost identical in FW and time-reversed BW. Therefore, in
Fig. 2. Mean GRF curves during FW and BW.
BW, the ankle dorsiflexed after the toe-strike and then plantar-
flexed during most of the support phase, and the knee extended
throughout the stance phase and flexed during most of the swing
phase, while the hip flexed during the stance phase and extended
during the swing phase. In addition, the moment pattern of the
ankle joint was almost identical in FW and time-reversed BW. In
knee and hip, the joint moment patterns of time-reversed BW were
simpler than those of FW, because of few peak points disappeared
in time-reversed BW.
In the ankle joint, the maximum plantarflexion moment was
generated during loading response during BW. In this phase, the
ankle decelerated to play an important part in shock absorption;
thus, the maximum plantarflexion moment and the greatest power
absorption occurred. According to several previous studies [6–8],
the plantarflexor muscles, the gastrocnemius and soleus, are
activated in this phase. These muscles are activated in order to
decelerate the ankle and absorb power. In midstance, the ankle
joint plantarflexed to move the trunk backward, causing the
greatest power generation during BW. Grasso et al. reported that
the main thrust is provided by knee and hip extensors during BW
[8]. However, during BW, the ankle joint generated much greater
power than the knee and the hip joints. Based on the results of our
power analysis, the ankle might be considered as a significant joint
for propulsion and shock absorption.
In the knee joint, the maximum power absorption at the loading
response was significantly smaller during BW than during FW. This
result indicated that the shock absorption at foot strike in the knee
joint was reduced during BW, because of the greater shock
absorption in the ankle joint. The power amplitude of the knee
joint decreased during BW because of a simpler pattern of knee
joint displacement. During initial contact in BW, the knee flexed
(60% gait cycle of Fig. 1b), and the knee extended during initial
contact to mid stance (60–25% gait cycle of Fig. 1b). The knee
slightly flexed in terminal stance to lower the body for opposite
foot contact and to prepare the backward propulsion of the body.
According to [6–8], the knee extensor muscles, the vastus lateralis,
vastus medialis, and rectus femoris, are activated from initial
678 M. Lee et al. / Gait & Posture 38 (2013) 674–678
contact to terminal stance. Because of these activations, the knee
joint is extended during this stance phase in order to prevent
descent of the body’s center of mass during BW. The knee joint
extended in pre-swing phase and flexed in the initial swing phase
to propel the foot backward, clear the foot over the ground, and
generate joint power.
Similar to previous reports [6,8], the hip joint was less flexed
and less extended during the entire gait cycle in BW. In loading
response, the hip joint flexed, and the hip joint generated the
maximum power during BW. The flexion moment was converted
to an extension moment during the terminal stance to maintain
the trunk vertically during BW. According to [6–8], the hamstring
is activated during pre-swing to initial contact. This muscle is
activated to hip extension during swing phase and braking knee
extension during swing phase.
The pattern of the vertical GRF curves differed between FW and
BW. GRFs increased rapidly to support the whole body weight
during the loading response. The knee flexed during mid-stance;
the force plate briefly unloaded, and the GRFs dropped below body
weight [12]. Similar to the findings of a previous report [8], the two
peaks were roughly symmetrical in FW, whereas in BW, the first
peak caused by the loading of the body weight was always greater
than the second peak caused by the heel push off. During BW, the
second peak of GRF was smaller than the first since the knee and
hip joints were merely lifting the limb and moving it backward.
Thus, a plateau shape not typically seen in FW was observed during
the pre-swing phase in BW.
BW is more difficult and demanding than FW due to postural
instability and no visual cue to progress [16]. However, compared
to FW, BW is potentially useful in rehabilitation in terms of greater
muscle and neural activities [6,8,17], higher heart rate and oxygen
consumption [1], and lower patellofemoral joint reaction forces
[2]. Motor learning mechanism is important to re-educate
impaired musculoskeletal function [18]. Hackney and Earhart
[17] demonstrated that backward direction generally more
impacted to people with Parkinson disease (PD) than a secondary
cognitive task, i.e. mental arithmetic task, during walking.
Especially, they also found that the gait asymmetry linked to
deprived attentional resources allocated to gait [19] was notable in
those with PD in the simple backward direction. In addition, many
studies reported that joint angle and moment patterns were
similar between FW and time-reversed BW [6–8]. EMG pattern
shift [7,8] and simpler shape of knee and hip joint moments could
be explained as the modification of neural mechanism [6]. Thus,
BW could be helpful to the motor learning caused by the
modification of the neural mechanism.
A limitation of this study is that electromyography (EMG) of the
lower limb muscles was not included to analyze the BW
mechanism. Further studies should be conducted to determine
the BW mechanism while considering EMG data of the lower limbs.
5. Conclusions
The aim of this study was to analyze gait mechanisms through
acquisition of data on the kinematic and kinetic patterns of BW and
FW. The characteristics of angular displacement in all joints were
almost identical in FW and time-reversed BW. However, selected
crucial points of joint angles were significantly different. In BW,
range of motion of all joints was significantly smaller than in FW.
The kinetic analysis of BW, which has rarely been studied
previously, was implemented in the current study. The moment
pattern of the ankle joint was almost identical in FW and time-
reversed BW. In the knee and hip joints, the joint moment pattern
of time-reversed BW was simpler than that for FW. The joint power
patterns of the ankle, knee and hip were different during FW and
BW. An original finding of this study was that the main propulsion
and shock absorption joint during BW was the ankle joint. The knee
and hip joints did not generate propulsion power. Further study
using EMG will help to determine the rehabilitation advantage of
BW.
Acknowledgements
This research was financially supported by the Technology
Innovation Program (Industrial Strategic Technology Development
Program, 10032055) funded by the Ministry of Knowledge
Economy (MKE, Korea), and was also supported by the Ministry
of Knowledge Economy (MKE) and Korea Institute for Advance-
ment of Technology (KIAT) through the Research and Development
for Regional Industry (70011192).
Conflict of interest statement
The authors have no conflict of interest regarding any of the
material in the manuscript and meet the criteria for authorship as
defined in your submission guidelines.
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