Low Back Pain, ChronicNCT07484542
Additional Effects of Retro Walking.
A study testing Retro walking and Core stabilization and Core Stabilization in people with Low Back Pain, Chronic, run by Riphah International University at 2 sites in Pakistan.
Trial summary
The aim of this study is to find the effects of retro walking along with core stabilization on pain, disability and balance in non-specific chronic low back pain patients. Randomized controlled trials will be done at Railway general hospital, Rawalpindi and Care plus medical center, Islamabad. The sample size was 42. Read more about this study
- Who is it for?
- Ages 25 to 50 years
- Conditions the study is for
- Low Back Pain, Chronic
- What is being tested?
- Retro walking and Core stabilization and Core Stabilization
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 2 sitesPakistan
- Study dates
- 28 Feb 2026to 1 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Subjects of either gender.
- Age range of 25-50 years.
- Subjects with non-specific chronic low back pain (more than 3 months).
- Subjects with Visual analogue score equal or more than 5.
Who cannot join
- Subjects with acute injury of spine.
- Subjects with ankylosing spondylitis.
- Patients with referred pain.
- Subjects with operative history of spine or hip.
- Pregnant females or child birth for less than 6 months.
- Subjects with any systemic disease or tuberculosis of spine.
Trial locations and contacts
2 sites in 1 country.
Pakistan2 sites
Care Plus Medical Center
Islamabad, Islamabad, 44000
Railway General Hospital
Rawalpindi, Punjab Province, 00666
About this study
Official title: Additional Effects of Retro Walking on Pain, Disability and Balance in Non-specific Low Back Pain
The aim of this study is to find the effects of retro walking along with core stabilization on pain, disability and balance in non-specific chronic low back pain patients. Randomized controlled trials will be done at Railway general hospital, Rawalpindi and Care plus medical center, Islamabad. The sample size was 42. The subjects were divided into two groups, 21 subjects in group A will undergo retro-walking along with core stabilization and 21 in group B will undergo only core stabilization exercises. Conventional physical therapy protocol will apply to both groups. Sampling technique applied was purposive nonprobability sampling technique. Only 25-40 years individual with chronic low back pain were included. Tools used in the study are visual analogue scale, Modified Oswestry Disability Index and gait and balance app. Data will be analyzed through Statistical Package for the Social Sciences version 21.
Read the detailed description
Low back pain is defined as the pain that typically originates above the inferior gluteal folds and below the costal margins. Low back pain is divided into specific low back pain that refers to the pain that originates due to any pathology and can be spinal or non-spinal in origin. Non-specific low back pain refers to the pain that persists without any identifiable cause such as tumor, infection, osteoporosis, fracture, cauda- equina syndrome, radicular pain and inflammatory disorders. It is highly reported musculoskeletal condition and represents a considerable health concern world-wide and the leading cause of disabilities and can occur in any age group which imposes burden both economically and socially on individuals as well as health care system. Non-specific low back pain is further divided into acute (<3 months of duration) and chronic (>3 months of pain duration). Low back pain is multifactorial in nature i.e. it can be biomechanical, neurological or psychological. Every individual once in life must encounter low back pain. Several risk factors are associated with low back pain such as genetic predisposition, superfluous dynamic or static loading, excessive bending and twisting movements, poor postural alignment, obesity, lack of physical activity, stress and anxiety. Several treatments are recommended for patients with low back pain including medication, short waves, infiltration, or blockade. Exercise therapy consists of a vast range of interventions such as aerobics, movements to improve flexibility and strength, stretching, stabilization, coordination and balance training. These treatment options are effective, but we want to explore techniques which are feasible and cost effective for patients with chronic low back pain.
Retro-walking, which is also known as retro-pulsion, or backward walking is proving to be valuable therapeutic technique in rehabilitation. This method first practiced in ancient China to work on physical fitness and well-being of clients. Retro- walking is different in its gait pattern from forward walking, for example speed and stride length decreased and cadence increased. It is confirmed that flexibility of hamstring is increased by retro-walking in healthy individuals. The gait pattern in retro-walking involves the leg swings backward with the knee bent. The toe touches the ground initially and then the knee gradually straightens up as the foot makes full contact with the ground. Retro-walking also helps in improvement of spinal alignment which can be disturbed due to low back pain. In contrast, core stabilization has been widely used in treatment of chronic low back pain. Several studies have observed that weakness of lumbar multifidi and transverse abdominis muscle and delayed tonic activation of these muscles during gait and movement can be the cause of chronic low back pain. Decreased functioning of these muscles can be the cause of lumbar instability, increase in stress and loads of the surrounding structures in lumbar spine. Core stability exercises are used to regain normal muscles functioning which can help in lumbar stability, neuromuscular control within the lumbar region and it also prevents shear forces that can cause injury to the lumbar spine.
According to the literature, a study assesses the effects of retro-walking and conventional physiotherapy treatment on students with low back pain. After 1 month of the treatment flexion range of motion of lumbar spine showed no significant changes between two groups but pain and balance of the group introduced with retro-walking showed a significant improvement. Another study study aimed at investigating the effects of retro walking verses core stabilization exercises on pain and function in the patients with mechanical low back pain. Pain and disability reduction is seen in both groups, but better results are observed with retro walking. A study on effectiveness of forward walking versus retro walking on Balance, Gait speed and Lower body functional strength among the elderly population. The result of this study shows significant improvement in balance, gait and lower body functional strength both with forward and backward walking, but backward walking shows better results. Another study assessed the effects of retro walking on pain, functional disability, quality of life and sleep problems in patients with chronic low back pain. years. After 3 weeks of intervention there is a significant decrease in pain observed in both groups, but the group introduced with retro walking showed a better improvement. A study on effect of retro walking on pain, functional disability and performance in knee osteoarthritis patients. After 6 weeks of intervention, it showed that the group with retro walking showed significant improvement.Another study on effect of core stabilization and strengthening exercises on proprioception, balance, muscle thickness and pain related outcomes in with chronic low back pain. After interventions of 4 weeks the group which introduced core stabilization shows better results than strengthening exercises.
- Conditions
- Low Back Pain, Chronic
- Being tested
- Retro walking and Core stabilization, Core Stabilization
- Keywords
- low back pain, Retro walking, core stabilization, Modified Oswestry Disability Index, Visual Analouge Scale, gait and balance app
- Medical subject headings
- Low Back Pain, Bronchiolitis Obliterans Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Retro walking and Core stabilizationOther
Retro walking group completed 10 minutes of retro walking training with 5-minutes warm-up and cool-down sessions 3 days a week for 6 weeks. The participants were instructed to gradually increase their walking time up to 30 minutes over the 6-week period.
Core stabilization:
With the patient in a supine position, core stabilization exercises will begin with basic activation techniques. In the first week and second week, the patient will perform Transverse abdominis drawing-in and Multifidus contraction with 2-5 seconds hold, 10 repetitions and 1 set. As week progress (3-6 weeks), same exercises with addition of bird-dog, bridging, plank with 10-30 seconds hold, up to 30 repetitions and 2 sets will be introduce.
In the warm-up and cool-down sessions, the subjects were instructed to perform heel raise exercises, ankle toe movements, and gastrocnemius-soleus and hamstring stretches.
Core StabilizationOther
With the patient in a supine position, core stabilization exercises will begin with basic activation techniques. In the first week and second week, the patient will perform Transverse abdominis drawing-in and Multifidus contraction with 2-5 seconds hold, 10 repetitions and 1 set. As week progress (3-6 weeks), same exercises with addition of bird-dog, bridging, plank with 10-30 seconds hold, up to 30 repetitions and 2 sets will be introduced. The participants in core stabilization group will undergo exercise program 3 times a week and for a duration of 6 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Retro-Walking and Core Stabilization | Experimental | Retro walking training along with core stabilization and transcutaneous electrical nerve stimulation and moist heat Receives: Other: Retro walking and Core stabilization |
| Core Stabilization | Active comparator | Core stabilization along with transcutaneous electrical nerve stimulation and moist heat Receives: Other: Core Stabilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Gait and balance app
Changes from baseline Gait and Balnace app was developed for smart phone built-in sesor to capture structrued movement data during standing and walking activites. The app collects motion data for six standardized tasks based on clinical gait and balance protocols:
Standing on a firm surface - eyes open Standing on a firm surface - eyes closed Standing on foam - eyes open Standing on foam - eyes closed Walking straight ahead Walking straight with head turns It produces numerical outcomes per task. It has no single score or risk level. It outputs raw numeric metrics for each domain. Researchers interpret these numeric outcomes relative to research context.
Measured: 6 weeks
Secondary outcomes (2)
Visual Analouge Scale
Changes from the baseline, it is a common tool measure subjective intesnsity of pain. Its value ranging from 0 to 10 in which 0 means no pain, mild pain (1-3), moderate pain (4-6), and severe pain (7-10).
Measured: 6 weeks
Modified Oswestry Disability Index
Changes from the baseloine, the Modified Oswestry Disability Index consists of 10 sections, each scored from 0 to 5, where higher scores indicate greater disability due to low back pain. Scores from all completed sections are summed to obtain a total raw score and then converted into a percentage by dividing by the maximum possible score (50 if all sections are completed) and multiplying by 100. The resulting percentage reflects the level of disability: 0-20% minimal, 21-40% moderate, 41-60% severe, 61-80% crippled, and 81-100% bed-bound. This scoring system enables objective quantification of functional impairment and monitoring of changes over time.
Measured: 6 week.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Mar 2026
- Study start28 Feb 2026
- Primary completion1 May 2026
- Study completion1 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Low Back Pain, ChronicStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Muhammad Affan Iqbal, PhD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07484542
- Sponsor's protocol ID
- RIPHAH/RCRAHS/REC/02270
- Status last verified
- Jul 2026
- First submitted
- 16 Mar 2026
- Last updated
- 20 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Additional Effects of Retro Walking on Pain, Disability and Balance in Non-specific Low Back Pain
- ClinicalTrials.gov ID
- NCT07484542
- Acronym / sponsor ID
- RIPHAH/RCRAHS/REC/02270
- Conditions
- Low Back Pain, Chronic
- Keywords
- low back pain, Retro walking, core stabilization, Modified Oswestry Disability Index, Visual Analouge Scale, gait and balance app
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 28 Feb 2026 (actual)
- Primary completion
- 1 May 2026 (actual)
- Study completion
- 1 Jun 2026 (actual)
- First posted
- 20 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to find the effects of retro walking along with core stabilization on pain, disability and balance in non-specific chronic low back pain patients. Randomized controlled trials will be done at Railway general hospital, Rawalpindi and Care plus medical center, Islamabad. The sample size was 42. The subjects were divided into two groups, 21 subjects in group A will undergo retro-walking along with core stabilization and 21 in group B will undergo only core stabilization exercises. Conventional physical therapy protocol will apply to both groups. Sampling technique applied was purposive nonprobability sampling technique. Only 25-40 years individual with chronic low back pain were included. Tools used in the study are visual analogue scale, Modified Oswestry Disability Index and gait and balance app. Data will be analyzed through Statistical Package for the Social Sciences version 21.
Detailed description
Low back pain is defined as the pain that typically originates above the inferior gluteal folds and below the costal margins. Low back pain is divided into specific low back pain that refers to the pain that originates due to any pathology and can be spinal or non-spinal in origin. Non-specific low back pain refers to the pain that persists without any identifiable cause such as tumor, infection, osteoporosis, fracture, cauda- equina syndrome, radicular pain and inflammatory disorders. It is highly reported musculoskeletal condition and represents a considerable health concern world-wide and the leading cause of disabilities and can occur in any age group which imposes burden both economically and socially on individuals as well as health care system. Non-specific low back pain is further divided into acute (<3 months of duration) and chronic (>3 months of pain duration). Low back pain is multifactorial in nature i.e. it can be biomechanical, neurological or psychological. Every individual once in life must encounter low back pain. Several risk factors are associated with low back pain such as genetic predisposition, superfluous dynamic or static loading, excessive bending and twisting movements, poor postural alignment, obesity, lack of physical activity, stress and anxiety. Several treatments are recommended for patients with low back pain including medication, short waves, infiltration, or blockade. Exercise therapy consists of a vast range of interventions such as aerobics, movements to improve flexibility and strength, stretching, stabilization, coordination and balance training. These treatment options are effective, but we want to explore techniques which are feasible and cost effective for patients with chronic low back pain.
Retro-walking, which is also known as retro-pulsion, or backward walking is proving to be valuable therapeutic technique in rehabilitation. This method first practiced in ancient China to work on physical fitness and well-being of clients. Retro- walking is different in its gait pattern from forward walking, for example speed and stride length decreased and cadence increased. It is confirmed that flexibility of hamstring is increased by retro-walking in healthy individuals. The gait pattern in retro-walking involves the leg swings backward with the knee bent. The toe touches the ground initially and then the knee gradually straightens up as the foot makes full contact with the ground. Retro-walking also helps in improvement of spinal alignment which can be disturbed due to low back pain. In contrast, core stabilization has been widely used in treatment of chronic low back pain. Several studies have observed that weakness of lumbar multifidi and transverse abdominis muscle and delayed tonic activation of these muscles during gait and movement can be the cause of chronic low back pain. Decreased functioning of these muscles can be the cause of lumbar instability, increase in stress and loads of the surrounding structures in lumbar spine. Core stability exercises are used to regain normal muscles functioning which can help in lumbar stability, neuromuscular control within the lumbar region and it also prevents shear forces that can cause injury to the lumbar spine.
According to the literature, a study assesses the effects of retro-walking and conventional physiotherapy treatment on students with low back pain. After 1 month of the treatment flexion range of motion of lumbar spine showed no significant changes between two groups but pain and balance of the group introduced with retro-walking showed a significant improvement. Another study study aimed at investigating the effects of retro walking verses core stabilization exercises on pain and function in the patients with mechanical low back pain. Pain and disability reduction is seen in both groups, but better results are observed with retro walking. A study on effectiveness of forward walking versus retro walking on Balance, Gait speed and Lower body functional strength among the elderly population. The result of this study shows significant improvement in balance, gait and lower body functional strength both with forward and backward walking, but backward walking shows better results. Another study assessed the effects of retro walking on pain, functional disability, quality of life and sleep problems in patients with chronic low back pain. years. After 3 weeks of intervention there is a significant decrease in pain observed in both groups, but the group introduced with retro walking showed a better improvement. A study on effect of retro walking on pain, functional disability and performance in knee osteoarthritis patients. After 6 weeks of intervention, it showed that the group with retro walking showed significant improvement.Another study on effect of core stabilization and strengthening exercises on proprioception, balance, muscle thickness and pain related outcomes in with chronic low back pain. After interventions of 4 weeks the group which introduced core stabilization shows better results than strengthening exercises.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Retro-Walking and Core Stabilization | Experimental | Other: Retro walking and Core stabilizationRetro walking training along with core stabilization and transcutaneous electrical nerve stimulation and moist heat |
| Core Stabilization | Active comparator | Other: Core StabilizationCore stabilization along with transcutaneous electrical nerve stimulation and moist heat |
Who may qualify
- Ages
- 25 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Subjects of either gender.
- Age range of 25-50 years.
- Subjects with non-specific chronic low back pain (more than 3 months).
- Subjects with Visual analogue score equal or more than 5.
Key exclusion criteria (6 listed)
- Subjects with acute injury of spine.
- Subjects with ankylosing spondylitis.
- Patients with referred pain.
- Subjects with operative history of spine or hip.
- Pregnant females or child birth for less than 6 months.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Retro walking and Core stabilizationRetro walking group completed 10 minutes of retro walking training with 5-minutes warm-up and cool-down sessions 3 days a week for 6 weeks. The participants were instructed to gradually increase their walking time up to 30 minutes over the 6-week period. Core stabilization: With the patient in a supine position, core stabilization exercises will begin with basic activation techniques. In the first week and second week, the patient will perform Transverse abdominis drawing-in and Multifidus contraction with 2-5 seconds hold, 10 repetitions and 1 set. As week progress (3-6 weeks), same exercises with addition of bird-dog, bridging, plank with 10-30 seconds hold, up to 30 repetitions and 2 sets will be introduce. In the warm-up and cool-down sessions, the subjects were instructed to perform heel raise exercises, ankle toe movements, and gastrocnemius-soleus and hamstring stretches. | Other | Retro-Walking and Core Stabilization |
| Core StabilizationWith the patient in a supine position, core stabilization exercises will begin with basic activation techniques. In the first week and second week, the patient will perform Transverse abdominis drawing-in and Multifidus contraction with 2-5 seconds hold, 10 repetitions and 1 set. As week progress (3-6 weeks), same exercises with addition of bird-dog, bridging, plank with 10-30 seconds hold, up to 30 repetitions and 2 sets will be introduced. The participants in core stabilization group will undergo exercise program 3 times a week and for a duration of 6 weeks. | Other | Core Stabilization |
Primary outcome
Gait and balance app
Time frame: 6 weeks
Changes from baseline Gait and Balnace app was developed for smart phone built-in sesor to capture structrued movement data during standing and walking activites. The app collects motion data for six standardized tasks based on clinical gait and balance protocols: Standing on a firm surface - eyes open Standing on a firm surface - eyes closed Standing on foam - eyes open Standing on foam - eyes closed Walking straight ahead Walking straight with head turns It produces numerical outcomes per task. It has no single score or risk level. It outputs raw numeric metrics for each domain. Researchers interpret these numeric outcomes relative to research context.
2 secondary outcomes
Visual Analouge Scale
Time frame: 6 weeks
Modified Oswestry Disability Index
Time frame: 6 week.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Muhammad Affan Iqbal, PhD* principal investigator
Riphah International University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Retro walking and Core stabilization and Core Stabilization in people with Low Back Pain, Chronic, run by Riphah International University at 2 sites in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Gait and balance app (time frame: 6 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jul 2026.