人體於陸上向後走時對神經肌肉的需求比向前走高，對髕股關節及膝關節的受力較小，故經常被運用於訓練下肢受傷的病患。水因具有浮力及阻力，能抵抗重力及提供緩衝力，故成為增進體適能與復健治療的方法之一。本文藉由回顧陸上向後走與水中向前向後走之相關研究文獻，探討水中與陸上向前向後走在神經肌肉、步態與能量需求上之差異。結果發現，在相同運動強度下，水中向前走與陸上相較，肌肉活化程度低於陸上運動，步頻變慢，步幅較小。當走路速度相同時，攝氧量、心跳率以及自覺努力程度在水中走路時較陸上為高，股四頭肌、腿後肌、腓腸肌肌肉活化程度較陸上高。水中向後走時椎邊肌、股內側肌及脛骨前肌較水中向前走用力，攝氧量及自覺努力程度較水中向前走高；若與陸上向後走比較，下肢肌肉活化程度皆低於陸上向後走，但椎邊肌的活化程度在有水流衝擊時大於陸上向後跑。對於已經受到衝擊性傷害的病患，可運用水中向後走來維持心肺功能，同時訓練下肢肌力。
The physical demand in human locomotion is higher during backward walking compares to forward walking. During backward walking, less compressive force is exerted on patellofemoral joint and on knee; therefore, backward walking can be used as a therapeutic training method for individuals with lower-extremities injures. The unique properties of water (buoyancyand resistance) provide anti-gravity force and prevent sudden impact during exercise, so water exercise may provide opportunities for injured individuals to increase fitness. This study was to compare the differences in muscle activity and gait characteristics of backward and forward walking on land and in water based on a qualitativereview. When walk in water, the buoyancy reduce weight bearing load and the resistance slow the motion; therefore, less impact force exert on muscles and joints. When walking at same intensity, muscle activity was lower during forward walking in water compared to forward walking on land. When walking at the same speed, the metabolic costs, heart rate and RPE were higher during forward walking in water compared with forward walking on land. Also, the muscleactivitywere lower in rectus abdominis, gluteus medius, vastusmedialis, rectus femoris, biceps femoris, tibialis anterior and gastrocnemius during backward walking in water when compared to backward walking on land; however, paraspinal muscles were higher when walk against water current. Backward walking in water maybe usedto increase cardiovascular fitness and strengthenparaspinal muscles for injured individuals.
