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Effectiveness of backward walking training on walking ability in children with hemiparetic cerebral palsy: a
Amr A Abdel-Aziem1, Heba My El-Basatiny2
11 Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Insights
Backward walking training significantly improved gait parameters and motor function in children with cerebral palsy compared to forward walking. These benefits were sustained one month post-intervention, highlighting its effectiveness.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) affects motor function, impacting gait and gross motor skills.
- Hemiparetic CP, a common subtype, presents specific challenges in walking and mobility.
- Conventional physical therapy is a cornerstone of CP management.
Purpose of the Study:
- To compare the efficacy of backward walking training versus forward walking training in children with hemiparetic cerebral palsy.
- To evaluate the impact on spatiotemporal gait parameters and gross motor function.
Main Methods:
- A randomized controlled trial involving 30 children (10-14 years) with hemiparetic CP (Gross Motor Function Classification System levels I-II).
- Participants received 12 weeks of conventional physical therapy, with one group additionally doing 25 minutes of backward walking and the other doing forward walking.
- Gait analysis and gross motor function measures were used for assessments at baseline, post-treatment, and 1-month follow-up.
Main Results:
- The backward walking group showed significant improvements in step length, walking velocity, cadence, stance, and swing phases.
- Gross motor function measures (Dimensions D and E) also significantly improved in the backward walking group.
- These improvements were maintained at the 1-month follow-up assessment.
Conclusions:
- Backward walking training, as an adjunct to conventional physical therapy, is more effective than forward walking training for improving gait and motor function in children with hemiparetic CP.
- The findings support the integration of backward walking into rehabilitation programs for this population.
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.
