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Published on: January 29, 2016
Structural and Functional Changes With 8 Weeks of Backward Walking Training in Multiple Sclerosis: A Case Series
Maryam M Abbawi1, Michael VanNostrand, Patrick G Monaghan
1Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, Michigan (M.M.A., M.V., P.G.M., T.N.T., B.Y., N.E.F.); Department of Health Care Sciences, Wayne State University, Detroit, Michigan (M.V., P.G.M., N.E.F.); Translational Neuroscience Program, Wayne State University, Detroit, Michigan (T.N.T., J.A.S., N.E.F.).;Department of Psychology, Wayne State University, Detroit, Michigan (A.M.D.); Department of Neurology, Wayne State University, Detroit, Michigan (N.E.F.); and Institute of Gerontology, Wayne State University, Detroit, Michigan (A.M.D.).
Backward walking training (BWT) in multiple sclerosis (MS) improved balance, mobility, and brain white matter microstructure. This 8-week intervention also reduced fall rates in individuals with MS.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Multiple sclerosis (MS) is characterized by progressive mobility decline and increased fall risk.
- Backward walking (BW) shows potential for improving mobility in MS.
- The impact of BW on reactive balance, physical activity, falls, and brain structure remains under-explored.
Purpose of the Study:
- To assess the feasibility and acceptability of an 8-week backward walking training (BWT) program in individuals with MS.
- To examine the effects of BWT on gait speed, static and reactive balance, fall incidence, and physical activity.
- To investigate concurrent changes in white matter microstructure using myelin water imaging (MWI) following BWT.
Main Methods:
- Eight ambulatory individuals with relapsing-remitting MS participated in the study.
- Participants underwent BWT for 8 weeks, combining laboratory and home-based sessions.
- Assessments included gait analysis, static and reactive balance tests, physical activity monitoring, prospective fall monitoring, and pre/post MWI.
Main Results:
- BWT was feasible (100% adherence) and acceptable (96.9% rating).
- Significant improvements were observed in static and reactive balance, BW velocity, and FW velocity.
- MWI revealed microstructural changes in white matter regions, and a reduction in fall rate was noted post-intervention.
Conclusions:
- Eight weeks of BWT is a feasible and acceptable intervention for individuals with MS.
- BWT demonstrates potential to induce structural and functional changes, including improved balance and reduced falls.
- Further research with larger sample sizes is warranted to confirm clinical significance and generalizability.
