Cerebral palsy (CP) causes permanent motor impairments, limiting postural control and mobility. The Dubousset Functional Test (DFT) was developed to assess daily activity performance, but its reliability and validity in pediatric CP are unclear. This study aimed to evaluate its reliability, convergent and discriminative validity, and clinical utility in children with spastic CP at GMFCS Levels I - II. Thirty-three children aged 6-15 years with spastic CP (GMFCS I - II) participated in this cross-sectional methodological study. The DFT (Rise-and-Walk, Step, Sit-to-Stand, and Dual Task subtests) was administered along with the Timed Up and Go (TUG), Dual-task TUG, 3-Meter Backward Walk Test (3MBWT), Functional Reach Test (FRT), and Pediatric Balance Scale (PBS). All assessments were conducted twice, seven days apart, by a single experienced physiotherapist. The DFT demonstrated excellent reliability, with ICC(3,2) values ranging from 0.91 to 0.95 and minimal measurement bias (-0.61 to 0.36 s). The smallest detectable change (SDC) ranged from 2.1 to 13.0 s, confirming high measurement precision. Strong correlations were observed between the DFT Dual Task and both TUG (r = 0.95, p < .001) and Dual-task TUG (r = 0.95, p < .001), supporting convergent validity. ROC analysis indicated excellent discriminative accuracy for identifying children with balance limitations (PBS < 45) (AUC = 0.82, sensitivity = 0.81, specificity = 0.78). The DFT is a reliable, valid, and clinically feasible tool for assessing balance and mobility in ambulatory children with spastic CP at GMFCS I - II, supporting routine rehabilitation use. ClinicalTrials.gov (NCT06831591).

Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review.

Effects of eight-week backward walking training on mechanical energy flow pattern and Achilles tendon properties in older adults with dynapenia: An exploratory study.

Objective: 3-Meter Backward Walk Test (3MBWT) is a physical performance-based test that assesses balance, proprioception, and fall risk. The present study aimed to reveal the reliability of the test-retest and the concurrent validity of 3MBWT in persons with knee osteoarthritis, which has not been studied yet. Patients and Methods: A total of 37 female patients were involved in the present study. 3MBWT was administered twice (one-week interval between sessions) in two different sessions, and the average score was recorded. The Timed Up and Go Test (TUG), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Modified Falls Efficacy Scale (MFES) were applied in the initial assessment to investigate correlations with 3MBWT. Results: The 3MBWT presented high intra-reliability (ICC=0.872). While, a strong correlation was observed between the 3MBWT and TUG (r=0.791), a moderate correlation was revealed between MFES and 3MBWT (r=-0.671). Significant correlations with the 3MBWT and KOOS subscales (ranging from – 0.726 to – 0.364) were also observed. The standard error of measurement (SEM) and the minimal detectable change (MDC95) were calculated as 2.36 and 6.55 seconds, respectively. Conclusion: 3MBWT is both a valid and reliable measurement tool in persons with knee osteoarthritis. It could be used to monitor the progression of the disease and the functional status of persons with knee osteoarthritis.

The Effect of Retro Walking Vs Slump Stretch on Hamstring Flexibility in Asymptomatic Female Population (Comparative Study)

Gait impairment and falls are common in multiple sclerosis (MS), yet the neural substrates contributing to mobility decline remain poorly understood. While prior studies have linked regional gray matter atrophy to motor outcomes, the role of diffuse cortical changes in complex gait tasks, such as backward walking, is less clear. This study examined whether diffuse cortical thinning is associated with forward and backward walking speed, and whether these relationships differ between fallers and nonfallers in MS. Forty-three individuals with MS (55 ± 10 years; 65% female) completed forward and backward Timed 25-Foot Walk assessments and high-resolution structural MRI. Cortical thickness and gray matter volume were estimated. Region-specific associations with gait speed were examined using regression with false discovery rate (FDR) correction. Principal component analysis revealed a global cortical thinning component that was associated with slower forward (β = -0.065, adjusted R2 = 0.14) and backward (β = -0.061, adjusted R2 = 0.19) walking speeds. In contrast, volumetric components did not significantly predict gait. Fallers and nonfallers did not differ in gait speed or cortical thinning, but exploratory moderation suggested stronger cortical thinning-gait associations in fallers, although effects did not remain significant after FDR correction. These preliminary findings suggest that diffuse cortical thinning is a consistent neural correlate of gait slowing in MS, with exploratory evidence suggesting that this relationship may be stronger among individuals with recent falls.

Exercise-assistance strategies are useful in allowing mobility-impaired patients to access the benefits of exercise. This trial is the first of the Reviver device, which facilitates exercise via a novel strength and balance training mechanism. The objective was to examine the effect of a 12-week Reviver intervention on symptoms of Parkinsonism, and to pilot the randomised controlled trial design, including randomisation and acceptance of the exercise intervention. This was a pilot, parallel-arm randomised controlled trial with assessor blinding. Participants (n=30: 22 with Parkinson's disease (PD) and 8 with atypical Parkinsonism conditions (AP)) were allocated to either experimental or control group. The experimental group received 24 sessions of 30 min on the Reviver over 12 weeks, the control group received their standard care. The Movement Disorders Society Unified Parkinson's Disease Rating Scale, and secondary outcomes (balance, gait, mobility, lower-body strength/coordination, tremor and grip strength) were acquired at endpoints the week prior to intervention commencement and the week after intervention termination. Recruitment progress, adherence to intervention, acceptability of intervention and adverse effects were also recorded. For the PD cohort, lower-body strength/coordination (5× Sit-To-Stand; b(95% CI)=-3.02 (-5.16 to -0.89), p=0.013), gait (self-selected walking speed; b=12.48 (2.18 to 22.78), p=0.029, stride length; b=9.75 (0.99 to 18.52), p=0.043) and backward walking speed (b=14.25 (1.93 to 26.57), p=0.038) were improved by the intervention. No significant effect of intervention on the outcome variables was found in the AP cohort. No serious adverse events were recorded. Median adherence to treatment was 95.8%. This pilot trial indicates that the Reviver is a safe and well-tolerated exercise-assistance intervention. The Reviver showed some indications of benefit in our secondary measures for PD participants, but not in our primary outcome. This was a small sample, short duration pilot study, and further studies with larger samples and higher exercise volume are warranted to fully assess the safety and efficacy of the device.

The Effects of Inclined Treadmill Backward Walking Training on Improving Turtle Neck

Background. Anterior cruciate ligament (ACL) reconstruction is frequently associated with persistent quadriceps weakness and reduced quality of life. Graded backward treadmill walking has emerged as a promising intervention to enhance neuromuscular rehabilitation. Objective. To investigate the effects of graded backward treadmill training on quadriceps strength, quadriceps muscle mass, and quality of life in individuals after ACL reconstruction. Methodology. Sixty participants (aged 18–45 years) who underwent ACL reconstruction using a semitendinosus graft were randomly assigned to five groups (A–E; n = 12 per group). Groups A–D performed backward treadmill walking at inclinations of 0°, 5°, 10°, and 15°, respectively. Group E served as the control group and received conventional rehabilitation. Training was conducted for 20 minutes per session, three days per week, for four weeks. Outcome measures included quadriceps strength (assessed using a dynamometer), quadriceps muscle mass (assessed by ultrasound), and quality of life (measured using the IKDC and ACL-QOL questionnaires). Statistical analyses were performed using analysis of variance (ANOVA) and non-parametric tests. Results. All groups demonstrated improvements in quadriceps strength, muscle mass, and quality of life following the intervention. Group B exhibited the greatest mean improvement in quadriceps strength, whereas Group D showed the largest increases in quadriceps muscle mass and quality of life scores. Significant between-group differences were observed at baseline for quadriceps strength (p &lt; 0.001) and at post-test for ultrasound-derived muscle mass (p = 0.010), IKDC scores (p = 0.033), and ACL-QOL scores (p = 0.016). Discussion. The findings indicate that backward treadmill training led to improvements in quadriceps strength, muscle mass, and quality of life across all intervention groups. The superior strength gains observed in Group B suggest that moderate incline backward walking may be optimal for enhancing force production, whereas the pronounced increases in muscle mass and quality of life in Group D indicate that higher inclinations may be particularly effective for promoting muscular hypertrophy and psychosocial recovery. Conclusion. Graded backward treadmill training following ACL reconstruction improves quadriceps muscle mass and quality of life, with higher inclinations showing greater effects. Further research is warranted to determine long-term outcomes and to identify optimal training parameters.

Structural and Functional Changes With 8 Weeks of Backward Walking Training in Multiple Sclerosis: A Case Series: Erratum.

Neuronal remodeling is essential for the precise formation of mature nervous systems. Drosophila serves to study neuronal remodeling; however, existing experimental systems are insufficient for examining circuit-level neuronal remodeling and its effect on behavior. We present a new model system to investigate neuronal remodeling. We show that the Moonwalker SEZ neuron, which elicits backward walking in adult flies, is part of a conserved circuit persisting from larva to adult. Utilizing the system, we examine developmental neuronal remodeling, describe a gene-regulatory mechanism controlling outgrowth, and uncover a causal relation between remodeling and behavior. The well-characterized connectivity of the circuit, low number of elements, direct control of the motor output, and availability of specific driver lines, provide an appealing system to study developmental remodeling of neuronal circuits and their impact on behavior. Hence, we establish a new model system in Drosophila to investigate neural circuit remodeling and its relation to behavior.

INTRODUCTION. The elderly are individuals who are in the final phase of life and have reached the age of 60 years or more. Along with ageing, the elderly experience various changes in physical, cognitive, emotional, and psychosocial aspects. In addition, the function of the sensory and musculoskeletal systems also decreases. In the musculoskeletal system, physiological changes that occur include decreased muscle strength, flexibility, elasticity, and limitations in joint range of motion. AIM. To determine the difference in effect between Dual-Task (Motor-Cognitive) and Walking Backward on elderly balance. MATERIALS AND METHODS. This research is an experimental study with a quasi-experimental design approach with a pre-and post-test design type, which divides the sample into two groups (two group samples). Group A and group B as treatment or experiment groups in the form of giving Dual-Task (Motor-Cognitive) for group A, for group B by giving Backward Walking. The sample comprise 60 people according to the inclusion criteria. Balance measurements were made using the Time Up Go Test (TUGT). RESULTS AND DISCUSSION. The statistical test results for the paired T-test demonstrate that the test results obtained for the Dual-Task (Motor-Cognitive) treatment group are p = 0.00 ( 0.05) and for the Backward Walking group obtained p = 0.00 ( 0.05) which means that both treatment groups are significant in improving the balance of the elderly. And the results of the independent t-test obtained a value of p = 0.048 ( 0.05). It can be interpreted that there is no significant difference in effect between Dual-Task (Motor-Cognitive) and Backward Walking on improving he balance of elderly individuals. CONCLUSION. The findings of this study suggest that the outcomes of the independent sample t-test for TUGT demonstrated a value of p = 0.048 (p 0.05). So it can be concluded that the two treatment groups have no significant difference in effect between Dual-Task (Motor-Cognitive) and Backward Walking on improving elderly balance.

BackgroundBehavioural data indicate the existence of a complementary “upper body strategy” for postural control, especially during challenging dynamic balance tasks; however, information about joint kinematics associated with this strategy is limited, leaving a gap in our understanding of the underlying movement patterns.ObjectiveThe objective was to investigate the influence of free vs. restricted arm movement strategies on balance outcomes and joint kinematics during challenging dynamic balance tasks.MethodsDynamic balance performance was assessed in 25 healthy young adults (13 females, mean age: 24.5 ± 3.1 years) using the Y Balance Test–Lower Quarter (YBT–LQ) and the 3-m Beam Walking Backward task with two difficulty levels (beam width: 4.5 cm vs. 3.0 cm). Participants performed the balance assessments under two different arm positions: free and restricted arm movements. Reach distance, step number, and joint range of motion (ROM) were compared between test conditions.ResultsFree compared to restricted arm movements led to significantly greater joint ROM, particularly in upper body segments such as the shoulder (p ≤ .001 to.002). Increased task difficulty also resulted in higher ROM across conditions (e.g., shoulder joint: p = .040 to.043), especially during free arm movements.ConclusionsThe increased joint ROM with free arm movements, particularly under increased task difficulty indicates an active engagement of the upper body segments during dynamic postural control. This highlights the importance of free arm movements to enhance balance control through greater joint mobility.

Individuals with multiple sclerosis (MS) experience mobility declines and an increased risk of falls. Studies in MS have suggested backward walking (BW) as a promising intervention to improve mobility, yet the impact of BW on reactive balance, physical activity, prospective falls, and brain structure has not been explored. The purpose of this case series was to examine feasibility, acceptability, and impact of 8 weeks of BW training (BWT) on gait speed, static and reactive balance, fall incidence, physical activity, and white matter microstructure. A secondary aim was to explore concurrent changes in structure and function with BWT. Eight ambulatory individuals with relapsing-remitting MS performed forward walking (FW) and BW, static and reactive balance tests, and underwent myelin water imaging (MWI) pre- (baseline) and post-intervention. MWI metrics were extracted from the body of the corpus callosum, superior cerebellar peduncle, and corticospinal tract. Physical activity was measured for 1 week before and after the intervention, and falls were monitored prospectively for 6months. Eight weeks of laboratory (1×/week) and home-based (2×/week) BWT; in the laboratory, individuals performed treadmill and overground BW followed by functional exercises incorporating backward stepping. At home, participants performed overground BW and the same functional exercises. BWT was feasible (100%) and acceptable (96.9%). All participants exhibited increased microstructural changes on the MWI metrics in at least 1 region of interest. Participants demonstrated decreases in sway area during static balance tasks (7/8), decreases in postural latency during reactive stepping (7/8), increases in BW velocity (6/8), and increases in FW velocity (4/8). There was a decrease in fall rate from baseline to 6months post-intervention (4/7). Eight weeks of BWT resulted in structural and functional changes; however, a larger sample size is needed to determine the clinical significance and generalizability of these findings. for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A564 .

Motor-cognitive (dual-task) training may enhance functional recovery after total knee arthroplasty (TKA). However, evidence for itsintegration into telerehabilitation programs is limited. To investigate the effects of motor-cognitive dual-task training on physical and cognitive performance in older adults undergoing TKA. A randomized controlled trial was conducted with 28 older adults undergoing TKA. Participants were assigned to a control group (CG;n=14), which received routine physiotherapy via telerehabilitation following one face-to-face session, or an intervention group (IG; n=14), whichreceived the same protocol plus an 8-week motor-cognitive dual-task training program. Pre- and post-intervention assessments included VisualAnalogue Scale (VAS), Knee Society Score (KSS), Mini-Mental State Examination, Dual Task Questionnaire, cognitive Timed Up and Go Test(cTUG), Lower Extremity Motor Coordination Test (LEMOCOT), 3-Meter Backward Walk Test (3-MBWT), 10-Meter Walk Test (10-MWT), WalkingImpact Scale (WALK-12), and Reaction Time Test. The IG demonstrated significantly greater improvements in both rest and activity VAS scores (p<0.001). Both groups showedimprovement in 3-MBWT performance (p<0.001), with the IG exhibiting superior gains (p=0.019). The IG also demonstrated greater improvement incTUG (p<0.001) and LEMOCOT scores (p<0.001). No additional benefits of dual-task training were observed for KSS symptom scores, gaitparameters (10-MWT, WALK-12), reaction time, or cognitive outcomes. Integrating dual-task training into telerehabilitation following TKA yields superior improvements in pain, dual-task performance, andsomatosensory-motor function in older adults. However, dual-task-specific exercises do not provide additional benefits regarding knee symptoms,gait speed, reaction time, or global cognitive performance compared with standard physiotherapy alone.

Introduction: Basketball is a high-intensity, semi-contact sport characterised by rapid multidirectional movements that place signifi cant strain on players’ musculoskeletal system, particularly the lower back. Retro walking or backward walking has recently emerged as a new concept in rehabilitation that has different pattern of muscle activation. It improves balance, posture, and muscle activity simultaneously reducing stress on the joint. Aim: To review the effect of retro walking on Low Back Pain (LBP) in basketball players. Materials and Methods: Randomised controlled trials published from 2018 to 2024 that explored retro walking’s impact on LBP and were openly accessible were included. A comprehensive literature review was conducted using various databases such as PubMed, Google Scholar, and Research Gate, using the following keywords: Retro Walking, Low Back Pain, Basketball Players, Performance Measures, Agility, Dynamic Balance, and Flexibility. After screening 10 free-full text articles were included in the review that fulfi lled the requirements of inclusion criteria. Results: Retro walking has a positive impact on both LBP and performance measures among basketball players. Participants who engaged in retro walking interventions experienced improved scores on pain assessment tools such as the numerical pain rating scale and Oswestry Disability Index. Additionally, retro walking contributed to enhanced dynamic balance, agility, and overall performance. Conclusion: The fi ndings from this review suggest that retro walking may offer a unique and effective intervention for managing low back pain and enhancing performance measures among basketball players. Further research is needed to validate these effects and establish retro walking as a standard part of rehabilitation and training regimens for athletes.

BackgroundThis study aims to evaluate the diagnostic potential of gait parameters in differentiating healthy elders, mild cognitive impairment (MCI), and Alzheimer’s disease (AD).Method263 individuals were enrolled in this study, involving 99 MCI patients, 61 possible mild AD patients, 46 possible moderate AD patients, and 57 controls (NC). Gait performance was detected through single‐task (normal speed and fast speed) and dual‐task (normal walking and counting backwards minus 3), recorded by three cameras (two on the side and one in the front). The RTMW model trained on the Cocktail14 dataset in the MMPose library was used to extract human key points from the captured gait videos. Kalman filtering was applied to remove high‐frequency noise, and the 'find peaks' function in the SciPy library was used to identify the lowest point of the footwork trajectory. Finally, we gained the gait parameters of stride speed (m/s), stride length (m), stride variation (%), and Dual‐task cost (DTC, %).ResultFirstly, in the single‐task, both normal and fast stride speed showed significant decline as the cognitive impairment aggravated, where there were statistical differences among the four groups (p <0.01). And the stride length of both normal and fast speed showed a significant decline in the possible AD (mild and moderate) group compared to controls (p <0.05). Secondly, in the dual‐task, stride speed significantly declined as cognition deteriorated, where the statistical differences can be observed between the MCI and control group (p <0.05), as well as possible AD (mild and moderate) and control group (p <0.01). Thirdly, fast stride speed in single‐task was the most optimal parameter in distinguishing MCI and control group (AUC=76.04%, specificity=60%, sensitivity=84.38%, Cut‐off=1.70m/s). Moreover, stride speed in single‐task exhibits great value in identifying AD from control, no matter normal stride speed (AUC=90.71%, specificity=80.3%, sensitivity=86.67%, Cut‐off=1.11m/s) or fast stride speed (AUC=90.35 %, specificity=77.27%, sensitivity=96.67%, Cut‐off=1.47m/s).ConclusionGait impairment can be significantly detected in MCI and possible AD, and stride speed and stride length would decline as cognition deteriorates. In single‐task, both normal and fast stride speed demonstrate optimal diagnostic efficacy in identifying both possible AD and MCI from controls.

The psychometric properties of the 3-m backward walk test in people with Migraine.

Humans can acquire and maintain motor skills throughout their lives through motor learning. Motor learning and skill acquisition are essential for rehabilitation after neurological disease or injury. Adaptation, the initial stage of motor learning, involves short-term changes in motor performance in response to a new demand in the person's environment. Repeated adaptation can improve skill performance and result in long-term skill retention. Locomotor adaptation has been extensively studied with split-belt treadmill paradigms. In this study we explored whether bidirectional walking (BDW) on a split-belt treadmill can induce short-term gait adaptations. Twelve healthy volunteers participated in our single session, starting with 2 min of forward walking (FW), followed by four 5-min blocks of BDW with a 1-min passive rest in between blocks, and ending with another 2-min block of FW. We recorded body kinematics and ground reaction forces throughout the experiment. Participants modified both temporal (interlimb phasing, double stance duration) and spatial (step length) aspects of gait to meet the mechanical demands of backward dual walking (BDW). Adaptation occurred rapidly, with bilateral reductions in step length, adjustments in stance and swing phase timing, alterations in interlimb phasing, and decreased double stance duration in the limb walking backward. Notably, only the backward-walking limb (right) exhibited persistent aftereffects upon return to FW. These results demonstrate that BDW elicits adaptations in both spatial and temporal gait parameters, with transient aftereffects consistent with short-term motor learning. To our knowledge, this is the first report characterizing such spatiotemporal adaptations during BDW.NEW & NOTEWORTHY In this study, we demonstrate that bidirectional walking, i.e. walking with symmetrical limb speeds but in opposite directions, induces spatiotemporal adjustments and adaptations that persist for several minutes upon returning to forward walking. This study serves to validate bidirectional walking as a complementary paradigm to other split-belt training paradigms with unique biomechanical characteristics to investigate locomotor adaptation and learning.

Background: Lower back pain (LBP) is a prevalent and common musculoskeletal issue that can affect both mobility and functional quality. Backward walking (retro-walking) has gained attention due to its ability to reduce pain and improve disability while maintaining strength, mobility, and balance in many other conditions. The aim of this study is to examine its therapeutic effectiveness in reducing the symptoms of pain related to postural low back pain and also improving functional abilities in adults aged 30–50 years. Purpose: The purpose of the study is to evaluate whether backward walking (retro-walking) can effectively reduce pain and improve daily functional activities in adults (aged 30–50 years) who are suffering from postural low back pain (LBP). Methods: Out of 69 individuals chosen on the basis of inclusion and exclusion criteria, a total of 34 participants with postural LBP were recruited and divided into Group A (control) and Group B (experimental). The six-week intervention for Group B included backward walking sessions three times per week, starting at 10 minutes per session and progressing to 30 minutes on a flat surface. Oswestry Disability Index (ODI) and Numerical Pain Rating Scale (NPRS) scores were recorded pre- and post-intervention. SPSS software was used for statistical analysis, with paired and unpaired t-tests assessing differences within and between groups. Results: Statistical evaluation revealed a significant reduction in pain scores post-intervention (p&lt;0.001) and an improvement in functional abilities in both groups. However, Group B experienced a greater decline in NPRS scores compared to Group A. Conclusion: Backward walking is an effective, non-invasive, and cost-efficient intervention for individuals with postural LBP. The study had a relatively small sample size, which limits its generalization. Also, the study was done for a shorter period; therefore, long-term effects remain unpredictable.