Immediate Effects of Backward Treadmill Walking on Gait and Balance in People Post-Stroke

BACKGROUND: Hemiparetic gait and impaired balance are common motor deficits following stroke. Backward walking has become an alternative mode of locomotive training and has shown positive outcomes. Limited studies investigated the effects of backward walking in people post-stroke. This study aimed to compare the immediate effects of backward versus forward walking on gait and balance in individuals post-stroke. METHODS: A total of 5 people post-stroke (aged 60.00±3.44) completed this study protocol. Participants performed a 15-minute treadmill walk either forward or backward on two separate visits at a comfortable speed. Spatiotemporal and kinematic gait variables including walking speed, cadence, stride length, and stride time were collected using a three-dimensional motion analysis system. Three balance tests, including Limit of Stability (LOS), Modified Clinical Test of Sensory Interaction on Balance, and Sit to Stand, were conducted using a computerized dynamic post urography system. Both gait and balance assessments took place immediately before and after the treadmill walking protocol. RESULTS: People post-stroke did not show significant differences in all spatiotemporal and kinematic gait variables after both FW and BW. People post-stroke, however, showed significant changes in two balance variables after BW: the MXE scores of the LOS test improved by 29% in the posterior direction (from 33.20±9.73 to 42.80±4.92, p.05) and by 7% in the lateral direction on the affected side of the body (from 90.20±14.45 to 96.40±11.52, p.05). None of the balance variables showed significant changes following FW. There was also no significant group x condition interaction in all gait and balance variables. CONCLUSION: Our findings suggest that BW can improve gait and balance in people post-stroke. The improvements seem to be more prominent in the affected side than the unaffected side of the body after BW. This study suggests that health professional may consider implementing BW in addition to FW for stroke rehabilitation focused on improving gait and balance.