Effect Of Backward Walking Training Research Articles

Effect of Backward Walking Versus Forward Walking Training on Balance Among Children with Cerebral Palsy

Background: Cerebral palsy is characterized by long-term impairments in movement and posture that limit an individual’s ability to perform daily activities. Effective rehabilitation methods, such as forward and backward walking training, can improve balance and functional mobility in children with cerebral palsy.Objective: To compare the effects of backward walking training versus forward walking training on balance in children with cerebral palsy.Methods: A randomized clinical trial was conducted with 20 children aged 7-14 years, recruited from Children’s Hospital and Jinnah Hospital, Lahore. Participants were randomly divided into two groups: Group A (Forward Walking Training) and Group B (Backward Walking Training). Each group underwent training three times per week for 40 minutes over four weeks. Balance and mobility were assessed using the Time-Up-and-Go (TUG) test, Pediatric Balance Scale (PBS), and Figure-8 Walk Test (FW8T). Statistical analysis was performed using SPSS version 25, with Mann-Whitney U test used for between-group comparisons.Results: The backward walking group showed significant improvements in TUG (p = 0.03), PBS (p = 0.01), and FW8T (p = 0.01) compared to the forward walking group.Conclusion: Backward walking training showed superior improvements in balance and functional mobility compared to forward walking training in children with cerebral palsy.

Comparative effects of Backward walking training and standing balance training on balance and risk of fall among parkinson patients.

Background: balance and risk of falls are common problems among People with Parkinson's disease (PD) which compromise their functional independence and quality of life. Various rehabilitation protocols are being used for these patients. Objective: To determine the effectiveness of backward walking training (BWT) and standing balance training (SBT) on balance, and risk of falls among Parkinson's patients. Methodology: A randomized controlled trial was conducted at General Hospital Lahore from June 2020 to March 2021. The Parkinson's Patients of stage 3 or 4 of lower extremity on Brunnstrom motor recovery and the ability to walk 14 m with or without a walking aid or orthosis were included in the study. The Berg Balance Scale was used to evaluate the balance and fall risk. Group A (n=15) received backward walking training and Group B (n=15), standing balance training. The participants were assessed at the baseline, after the 6th week, and after 12 weeks of intervention. Results: The mean age of participants was 50.03+8.36 years. A total of n=17 participants were male while 13 were female. The result showed that group A received backward walking training (BWT) had a significantly large mean difference (22.13+-2.35 vs. 18.20.3.58, 95%CI (1.64,6.22) in BSS score as compared to group B received standing balance training (SBT). Conclusion: The study concluded that standing balance training and backward walking training both are effective, but backward walking training is more effective in improving balance and the risk of falls in Parkinson's patients.

Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study

BackgroundBackward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). MethodNineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. ResultsAfter training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). ConclusionBWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.

Addition of backward walking training to forward walking training improves walking speed in children with cerebral palsy: a systematic review with meta-analysis.

The objective was to examine the effects of backward walking training for improving walking speed and balance in children with cerebral palsy. A systematic review of randomized trials was conducted. Trials had to include children with cerebral palsy, with a Gross Motor Function Classification System, between I and III, that delivered backward walking training as a solo intervention or in combination with forward walking training. The outcomes of interest were walking speed and balance. The methodological quality of included trials was assessed by the PEDro scale, and the quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight papers, involving 156 participants, were included. Using random-effects meta-analysis, we estimated that backward walking training improved walking speed by 0.10 m/s [95% confidence interval (CI) 0.05-0.16] and by 2 points on the Pediatric Balance Scale (0-56) (95% CI 1.5-2.2) more than forward walking training. We also estimated that the addition of backward walking training increased walking speed by 0.20 m/s (95% CI 0.07-0.34) and reduced the angular excursion of the center of gravity by 0.5 degrees (95% CI -0.7 to -0.3). The quality of the evidence was classified as low to moderate. In conclusion, overall, backward walking training appears to be as effective or slightly superior to forward walking training for improving walking speed in children with CP. The addition of backward walking training statistically significantly and clinically important enhanced benefits on walking speed.

EFFECTS OF BACKWARD WALKING ON GAIT PARAMETERS IN PEOPLE WITH STROKE: A SYSTEMATIC REVIEW

According to the Centers for Disease Control, roughly 795,000 people in the United States experience a stroke each year. A common result of a stroke is the negative impact on the person’s gait, including an asymmetrical gait pattern, a slower cadence, and decreased stride and step lengths. A well-structured, comprehensive rehabilitation program is necessary to address the gait deficits and reduce the risk of falls in people following stroke. Backward walking training has been reported as an appropriate therapeutic intervention to address these deficits for people following a stroke. Due to the range of benefits reported, the purpose of this systematic review was to examine the effects of backward walking training on gait parameters in people following stroke. A search of Embase, CINAHL, and PubMed databases was performed using specific search terms related to backward walking, stroke, and gait parameters. Following a defined process of title screen, abstract screen, full text screen, and application of inclusion/exclusion criteria, six articles were included in the final systematic review. Study results indicate significant evidence within the experimental groups for improvement in gait speed, step length, stride length, endurance, and balance. The findings from this systematic review indicate that backward walking training is an effective therapeutic intervention to improve gait parameters in people following stroke.

Backward Walking Training Impacts Positive Effect on Improving Walking Capacity after Stroke: A Meta-Analysis.

Objective: The meta-analysis aimed to investigate the potential effect of backward walking training (BWT) on walking function improvement among stroke patients. Data sources: Eligible studies were systematically searched in PubMed, Embase, Web of Science, and Cochrane Library. Methods: Heterogeneity among enrolled studies was assessed. Weighted mean difference (WMD) with its 95% confidence interval (CI) was used to pool the outcomes. Results: Seven articles were included. BWT significantly improved motor functions of stroke patients including 10-meter walk test (WMD (95% CI) = 0.11 (0.01, 0.21) meters/second; p = 0.03); cadence (WMD (95% CI) = 4.00 (0.99, 7.02) step/minute; p < 0.01); Berg balance scale (WMD (95% CI) = 4.38 (2.60, 6.15); p < 0.01); paretic step length (WMD (95% CI) = 5.32 (1.97, 8.67) cm; p < 0.01); and stride length (WMD (95% CI) = 6.61 (0.70, 12.51) cm; p = 0.03) as compared with control group. Conclusion: Our study revealed that BWT had a positive influence on walking function improvement among patients after stroke.

Effect of backward walking training on foot posture and balance in flat foot adults

IntroductionFlat foot changes the posture of the foot and affects dynamic balance. Backward walking is a novelty in rehabilitative clinic; it improves strength and balance. The aim of this study was to investigate the effect of backward walking training on foot posture and dynamic balance in flat foot subjects.MethodsOverall, 44 participants with bilateral mobile flat foot, aged 19–35 years, were randomly assigned to 2 equal groups. Group A received backward walking training 3 times/week for 6 weeks, in addition to traditional physical therapy exercises. Group B received traditional physical therapy exercises only, 3 times/week for 6 weeks. Before and after treatment, foot posture was assessed with the Foot Posture Index and balance was evaluated with the HUMAC Balance System through the Limits of Stability test.ResultsStatistical analysis revealed a significant reduction in the Foot Posture Index and a significant increase of the Limits of Stability in both groups after treatment compared with the pre-treatment status (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Comparison between the groups after treatment showed a significant decrease in the Foot Posture Index in group A compared with group B (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and a significant increase in the Limits of Stability in group A compared with group B (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).ConclusionsBackward walking training as an addition to physical therapy exercises of flat foot can improve foot posture and enhance balance in comparison with physical therapy exercises alone.

Effect of backward walking training on knee osteoarthritis: protocol of a systematic review and meta-analysis.

IntroductionBackward walking (BW) is otherwise known as retrowalking. As opposed to forward walking, BW is a countersequential exercise and is a common method of rehabilitation training and disease-assisted treatment. Studies have shown that BW has a helpful effect on improving lower limb proprioception, gait synergy and improving limb balance. Many studies have concluded that BW can improve the symptoms of patients with knee osteoarthritis (KOA) and can be used for rehabilitation and adjunctive treatment of KOA, but there is a lack of evidence-based medical evidence. This research aims to provide an update to the most recent available evidence on the effect of BW on patients with KOA.Methods and analysesElectronic databases, such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed, will be searched by us. We will include studies identified from citation until 12 May 2020 and will not be restricted by geographical setting. The search will not be limited to the language of the publication, but the study of human subjects. Randomised controlled trials (RCTs) on the BW training of KOA will be included, with outcome measures including pain, knee function or balance function. The quality of included RCTs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. A meta-analysis or systematic review will be performed to summarise the effects of BW training. We will perform sensitivity analysis on the sample size of RCTs, meta-regression analysis of the follow-up periods, dosages and baselines of outcome measures, and publication bias analysis.Ethics and disseminationEthical approval is not required as this study will not involve confidential personal data. The results of this study will be disseminated through a peer-reviewed journal.PROSPERO registration numberCRD42020185694.

Effects of Backward Walking Training on Balance, Mobility, and Gait in Community-Dwelling Older Adults

ABSTRACT Background and Purpose: Backwards walking has shown promise as an intervention in many at-risk populations. The purpose of this study was to determine the benefits of backward walking training on balance, mobility, and plantar flexor endurance in individuals 60 years of age and older. Methods: Participants were community-dwelling, ambulatory older adults. The kinematics of forward and backward walking, the Mini BESTest, timed-up-and-go test, four-square step test, Activity-Specific Balance Confidence Scale, and single heel-rise test were performed. The control group were tested and re-tested five weeks later. The intervention group was tested at baseline and following ten backward-walking training sessions. Results: The training group improved on the Dynamic Gait subsection of the Mini-BESTest, the timed-up-and-go test, the number of heel-rises and the total work done in the heel-rise test. The control group did not improve in these measures, although they generally had better function at baseline than the intervention group. Conclusion: Backward walking training benefits plantar flexor endurance and dynamic balance during gait. These results justify further study in frailer older adults and a more rigorous study design.

Abstract 46: A New Rehabilitation Strategy to Improve Gait Speed and Balance Self-Efficacy Following Stroke

Introduction: Impaired balance and decreased balance confidence contribute to slow gait speed and increased fall risk post-stroke. Standard balance exercises and gait training do not adequately address these impairments. Backward Walking Training (BWT), incorporating the unique postural and lower extremity motor control demands of walking backward, may reduce these gait impairments. This study compared the effects of BWT to Forward Walking Training (FWT) on forward and backward gait speed, dynamic balance and balance confidence. Methods: Thirty adults with first time stroke (18 male; 15 right hemisphere lesion; mean time post-stroke 12.7±6.6 months; mean age 58.8±10.1 yrs; mean Lower Extremity Fugl-Meyer Motor Score 22.7±1.4) were randomized to receive eighteen exercise sessions (3x/week for 6 weeks) of BWT (n=15) or FWT (n=15) consisting of 20 minutes training on a treadmill with Body Weight Support followed by 20 minutes overground. Gait was facilitated by a physical therapist-led team. Speed, limb loading and bout duration were progressed across sessions. The Ten Meter Walk Test (10MWT), Activities-Specific Balance Confidence (ABC) Scale, 3-meter Backward Walk Test (3MBWT), Functional Gait Assessment (FGA) and spatial-temporal gait characteristics were assessed pre- and post-intervention. Results: Pre- to post-intervention increases in the 3MBWT (BWT: 0.23±0.4 to 0.32±0.06 m/s ; FWT 0.21±0.4 to 0.23±0.04 m/s: ), ABC (BWT: 55.2±5.2% to 61.8±7.1% ; FWT: 52.9±6.5% to 53.5±6.2%: ), 10MWT (BWT: 0.42±0.07 to 0.51±0.08 m/s ; FWT: 0.44±0.08 to 0.47±0.07 m/s ) and backward paretic step length (BWT: 0.19±0.04 to 0.34±0.03 cm ; FWT: 0.21±0.03 to 0.20±0.04 cm were greater for the BWT than the FWT group. These gains were all statistically significant (p &lt; 0.01). Group differences in FGA did not reach statistical significance. Conclusions: The greater increase in backward paretic step length, backward walking speed and balance confidence observed in the BWT group are all known contributors to reduced fall risk. BWT may be an important addition to the rehabilitation plan for individuals post-stroke. A longitudinal examination of fall incidence following BWT is the next important step in determining the overall utility of this novel rehabilitation approach.

Effects of Backward Walking Training with Task Orientation on the Functional Gait of Children with Spastic Hemiplegia

Purpose: This study examined the effects of backward walking training with task orientation on the functional walking ability of children with cerebral palsy. Methods: This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation facili ty with cross-over to the other intervention arm following a two-week break. For a total of 12 children with spastic hemiplegia cerebral palsy, the forward walking training group (n=6) underwent training three times a week for three weeks, 40 minutes a day, and the back ward walking training group (n=6) was also trained under the same conditions. To identify the functional walking ability, variables, such as the walking speed, stride length, and step length, were measured using a walk analyzer (OptoGait, Microgate S.r.l, Italy). Results: Both groups showed significant increases in walking speed, stride length, and step length (p<0.01). The backward walking group showed more significant improvement in the walking speed from pre- to post-test (p<0.05). The gait characteristics were similar in the two groups (stride length and step length) but the walking speed in the backward walking group showed a mean difference be tween the positive effects higher than the forward walking group. Conclusion: Task-oriented backward walking training, which was conducted on the ground, may be a more effective treatment approach for improving the walking functions of spastic hemiplegia children than forward walk training.

후방보행훈련이 만성기 뇌졸중 환자의 정적 균형, 균형 자신감과 보행지구력에 미치는 영향

후방보행훈련이 만성기 뇌졸중 환자의 정적 균형, 균형 자신감과 보행지구력에 미치는 영향

Effect of backward walking training using an underwater treadmill on muscle strength, proprioception and gait ability in persons with stroke

Objective: The purpose of this study was to investigate the effects of backward treadmill gait training between underwater and ground environments on...

The Effects of Backward Walking Training With Inclined Treadmill on the Gait in Chronic Stroke Patients

The Effects of Backward Walking Training With Inclined Treadmill on the Gait in Chronic Stroke Patients

Effect of Backward Walking Training on Improves Postural Stability in Children with Down syndrome

Background Motor intervention plays an important role in reducing the disabilities of Down syndrome (DS). A lack of balance and postural control has created motor problems in DS patients. Therefore, the aim of this study was to examine the effect of backward walking on postural stability of DS patients. Materials and Methods Sixteen DS children with 8-10 age range were selected by convenience sampling method and assigned to control and experimental groups. The experimental group performed backward walking training for 8 weeks (2 sessions per week, each session for 25 min). The dynamic postural stability of both groups was examined by Biodex stability system (general balance, medial collateral and anterior-posterior balance indexes) before, during and after the training (pretest, 4th week, 8th week and 18th week). To analyze the data and test the hypotheses, independent t test was used. Results The results of this study showed that the three balance indexes in the experimental group was drastically lower than the control group after 8 weeks of backward walking training (P˂0.01). In addition, significant differences could be observed in balance indexes even 10 weeks after the last session of the backward walking training (P˂0.05). Conclusion It seems that the findings of this study have confirmed the effect of backward walking training on the improvement of postural stability and Syndrome children with 8-10 age range can benefit from this method.

Effectiveness of backward walking training on walking ability in children with hemiparetic cerebral palsy: a randomized controlled trial

Objective: To compare the effects of backward walking training and forward walking training on spatiotemporal gait parameters, and gross motor function measures in children with cerebral palsy. Design: Randomized controlled clinical trial. Setting: Physical therapy clinics. Subjects: A total of 30 children with hemiparetic cerebral palsy of both sexes (10 to 14 years of age, classified as I or II by gross motor function classification system) participated in this study. They were randomly assigned into two equal groups. Interventions: Both groups received a conventional physical therapy program for 12 successive weeks (three sessions per week). The experimental group additionally received (25 min) backward walking training. The control group additionally received (25 min) forward walking training. Outcome measures: Baseline, posttreatment, and follow-up assessment for spatiotemporal gait parameters and gross motor functions were evaluated by using three dimensional gait analysis system and gross motor function measures. Results: There was a significant improvement in step length, walking velocity, cadence, stance phase, and swing phase percentage and gross motor function measures (Dimensions D and E) of the experimental group (0.55 ±0.16, 0.53 ±0.19, 121.73 ±2.89, 54.73 ±1.67, 44.40 ±1.40, 90.20 ±6.44, 82.47 ±12.82), respectively, than the control group (0.39 ±0.13, 0.46 ±0.20, 125.80 ±2.96, 50.27 ±1.62, 49.47 ±1.55, 82.47 ±7.05, 80.47 ±12.61), respectively, (p < 0.05). The significant improvement of all measured outcomes of the experimental group was maintained at 1 month follow-up assessment (p < 0.05). Conclusion: In addition to a conventional physical therapy program, backward walking training is more effective than forward walking training on spatiotemporal gait parameters, and gross motor function measures in children with hemiparetic cerebral palsy.

후방보행 훈련이 뇌졸중 환자의 균형능력 및 보행에 미치는 영향

본 연구의 목적은 뇌졸중 환자를 대상으로 후방보행 훈련이 균형능력(기능적 보행 검사, 일어나 걸어가기 검사) 및 보행(10 미터 보행검사)에 미치는 영향을 알아보고자 하였다. 이를 위해 18명의 뇌졸중 환자를 대상으로 실험군과 대조군에 각각 9명씩 무작위로 배정하였다. 두 그룹 모두 일반적인 신경학적 재활 물리치료를 1회 45분씩 주당 5회 4주 동안 실시하였으며, 실험군에는 후방보행 훈련을 4주 동안 1회당 20분씩 주당 3회를 추가하여 실시하였다. 후방보행 훈련 후 균형능력을 평가한 결과 기능적 보행평가는 <TEX>$17.67{\pm}1.00$</TEX>점에서 <TEX>$19.22{\pm}1.10$</TEX>점으로 상승하였고(p<.05), 일어나 걸어가기 검사에서는 <TEX>$26.45{\pm}1.37$</TEX>초에서 <TEX>$23.28{\pm}1.35$</TEX>초로 감소하여 유의하게 향상되었다(p<.05). 후방보행 훈련 후 10 미터 보행검사에서도 <TEX>$21.74{\pm}1.35$</TEX>초에서 <TEX>$18.33{\pm}1.10$</TEX>초 감소하여 유의하게 향상되었다(p<.05). 따라서 뇌졸중 환자에게 후방보행 훈련을 적용하면 균형능력(기능적 보행평가, 일어나 걸어가기 검사) 및 보행(10 미터 보행 검사)에 향상을 가져옴으로 유용한 운동치료의 프로그램으로 제안할 수 있을 것이다. The purpose of this study was to examine the effect of backward walking training on the balance capability(Functional Gait Assessment; FGA, Timed Up & Go Test; TUG) and gait performance(10 meter Walking Test; 10 mWT) of stroke patients. Eighteen with stroke patients were randomly allocated to an experimental and contral group of nine patients each. both groups received general neurorehabilitative physical therapy for 45 minutes per day 5 times per week during 4 weeks. The experimental group also performed additional backward walking training for 20 minutes per day 3 times per week during 4 weeks. There were signicantly increase by backward walking training in outcome of the balance capability from the FGA was increase from <TEX>$17.67{\pm}1.00scores$</TEX> to <TEX>$19.22{\pm}1.00scores$</TEX>(p<.05), TUG was decrease from <TEX>$26.45{\pm}1.37sec$</TEX> to <TEX>$23.28{\pm}1.35sec$</TEX>(p<.05) and 10 mWT was decreased from <TEX>$21.74{\pm}1.35sec$</TEX> to <TEX>$18.33{\pm}1.10sec$</TEX> (p<.05). These result suggest that backward walking training for stroke patients is effective in improving balance capability(FGA, TUG) and gait performance(10 mWT).

Effect of backward walking training on postural balance in children with hemiparetic cerebral palsy: a randomized controlled study

Objective: To study the effect of additional backward walking training on postural control in children with hemiparetic cerebral palsy. Design: Randomized controlled study. Setting: Physical therapy clinics. Subjects: Thirty spastic hemiparetic cerebral palsied children of both sexes (10-14 years, 14 girls and 16 boys). Intervention: Children were randomly assigned into two equal groups: experimental and control groups. Both groups received a traditional physical therapy program for 12 weeks. Experimental group additionally received backward walking training which was provided 25 min/day, 3 days/week for 3 successive months. Outcome measures: Baseline and post-treatment assessment for overall, anteroposterior, and mediolateral stability indices were evaluated by using Biodex balance system. Results: After treatment; two way ANOVA revealed significant improvement in overall, anteroposterior and mediolateral stability indices of experimental group at the most stable level (level 12) and moderately unstable level (level 7) (1.40 ± 0.44 and 1.73 ± 0.51; 1.11 ± 0.34 and 2.13 ± 0.52; 1.93 ± 0.51 and 2.68 ± 0.52) respectively, than control group (1.77 ± 0.44 and 2.17 ± 0.56; 1.44 ± 0.44 and 2.54 ± 0.49; 2.39 ± 0.65 and 3.11 ± 0.49) respectively, (P < 0.05). There were significant improvement in all measured variables for both groups at both levels (P < 0.05). Conclusion: Additional backward walking training to traditional physical therapy program yields improvement in postural stability indices in children with spastic hemiparetic cerebral palsy than traditional physical therapy alone.