Association between Backward Walking and Cognition in Parkinson Disease: A Systematic Review

Backward walking often occurs in everyday life. It is more complex than forward walking and is associated with decreased coordination. However, it is unclear if a reduced backward walking performance is associated with impaired cognition. This could be particularly relevant as gait and cognitive deficits commonly occur in Parkinson's disease. The objective of this systematic review was to synthesize the evidence on the association between backward walking and cognition in persons with Parkinson's disease. The electronic databases PubMed and Web of Science were systematically searched, and the quality of eligible studies was assessed. Two studies met the inclusion criteria, but study protocols, investigated population, and outcome measures differed substantially. One study showed lower backward walking speed in patients with Parkinson's disease with poorer attention test performances. The second study showed a weak correlation between executive cognitive functions and backward walking speed. Given the low number of studies, the heterogenous study design, and the inconsistent results, the present review highlights the need to further investigate the association between backward walking and cognition in patients with Parkinson's disease.