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Published on: May 16, 2025
A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled
Dorian K Rose1, Lou DeMark, Emily J Fox
1Department of Physical Therapy, University of Florida, Gainesville (D.K.R., E.J.F.); Malcom Randall VA Medical Center, Gainesville, Florida (D.K.R., D.J.C.); Brooks Rehabilitation, Jacksonville, Florida (D.K.R., L.D., E.J.F.); Department of Aging, University of Florida, Gainesville (D.J.C.); and University of North Florida, Jacksonville (P.W.).
Backward Walking Training (BWT) improved walking speed and balance in acute stroke patients more than Standing Balance Training (SBT). BWT is a feasible addition to inpatient rehabilitation for stroke survivors.
Area of Science:
- Neurology
- Physical Therapy
- Rehabilitation Medicine
Background:
- Gait and balance deficits are common early poststroke, with limited early intervention strategies.
- Backward Walking Training (BWT) may enhance postural and motor control, potentially improving balance and walking speed.
Purpose of the Study:
- To determine the feasibility of implementing BWT during inpatient rehabilitation.
- To compare the efficacy of BWT versus Standing Balance Training (SBT) on walking speed, balance, and confidence in acute stroke patients.
Main Methods:
- Eighteen individuals within one week poststroke were randomized to receive eight 30-minute sessions of BWT or SBT.
- Standardized tests including the 5-Meter Walk Test and Berg Balance Scale were used for pre- and post-intervention assessments.
Main Results:
- BWT led to significantly greater improvements in both forward (0.75 m/s) and backward (0.53 m/s) walking speeds compared to SBT.
- Large effect sizes were observed for balance confidence (Activities-Specific Balance Confidence Scale) with BWT.
Conclusions:
- Backward Walking Training is a feasible and effective intervention for acute stroke rehabilitation.
- BWT demonstrated superior outcomes in improving walking speed and balance compared to SBT.
- Further research should explore BWT's potential in fall prevention poststroke.
