Reproducibility of distance and direction errors associated with forward, backward, and sideway walking in the...

The ability to navigate without vision towards a previously seen target has been extensively studied, but its reliability over time has yet to be established. Our aims were to determine distance and direction errors made during blind navigation across four different directions involving three different gait patterns (stepping forward, stepping sideway, and stepping backward), and to establish the test-retest reproducibility of these errors. Twenty young healthy adults participated in two testing sessions separated by 7 days. They were shown targets located, respectively, 8 m ahead, 8 m behind, and 8 m to their right and left. With vision occluded by opaque goggles, they walked forward (target ahead), backward (target behind), and sideway (right and left targets) until they perceived to be on the target. Subjects were not provided with feedback about their performance. Walked distance, angular deviation, and body rotation were measured. The mean estimated distance error was similar across the four walking directions and ranged from 16 to 80 cm with respect to the 8 m target. In contrast, direction errors were significantly larger during sideway navigation (walking in the frontal plane: leftward, 10 degrees +/- 15 degrees deviation; rightward, 18 degrees +/- 13 degrees) than during forward and backward navigation (walking in the sagittal plane). In general, distance and direction errors were only moderately reproducible between the two sessions [intraclass correlation coefficients (ICCs) ranging from 0.682 to 0.705]. Among the four directions, rightward navigation showed the best reproducibility with ICCs ranging from 0.607 to 0.726, and backward navigation had the worst reliability with ICCs ranging from 0.094 to 0.554. These findings indicate that errors associated with blind navigation across different walking directions and involving different gait patterns are only moderately to poorly reproducible on repeated testing, especially for walking backward. The biomechanical constraints and increased cognitive loading imposed by changing the walking pattern to backward stepping may underlie the poor performance in this direction.