Effectiveness of 4-week backward walking training program incorporated with rhythmic auditory cueing on spatial and temporal gait parameters and balance in subjects with hemiparesis: An experimental randomized control trial

Abstract

AIM: The aim of the study was to investigate the effectiveness of a 4-week backward walking training (BWT) program incorporated with rhythmic auditory cueing on spatial and temporal gait parameters and balance in subjects with hemiparesis. MATERIALS AND METHODS: This was a experimental randomized control trial and random allocation was done using chit method. The study was conducted in the physiotherapy department with required infrastructure of tertiary health-care center. Forty subjects (male/female) aged 18–60, in Brunnstrom recovery stage 3, 4, and 5, and diagnosed with hemiparesis from onset to 2 years' duration were included in the study. Each subject was assessed for stride length, step length (paretic and nonparetic), cadence, walking velocity, 3-meters (3-m) backward walk test, Dynamic Gait Index (DGI), and Berg's Balance Scale (BBS) at baseline and 4 weeks post intervention. In addition to conventional physiotherapy exercises, Group A, experimental (n = 20), underwent backward walking training with rhythmic auditory cueing using metronome and Group B, control (n = 20), underwent backward walking training without rhythmic auditory cueing for 4 weeks. RESULTS: Post 4 weeks of training, in the experimental group,cadence improved by 20%(5% in control group), walking velocity reduced by 15% (0.3% control group), 3-m BWT reduced by 32% (20% in the control group), DGI improved by 40% (20% control group), and BBS improved by 20% (12% in the control group). There was no statistically significant improvement in stride length and step length in both the groups. CONCLUSIONS: It is concluded that backward walking training incorporated with rhythmic auditory cueing and conventional physiotherapy exercises is effective in improving cadence, walking velocity, 3-m backward walk test, DGI, and BBS in stroke subjects.