Backward Incline Walking in Stroke Rehabilitation: A Pilot Feasibility Study.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomechanics

Background:

• Restoring normal gait function after stroke is a significant clinical challenge.
• Backward walking and incline walking increase neuromotor demands, potentially benefiting stroke rehabilitation.
• The feasibility and safety of backward incline walking in chronic stroke patients remain underexplored.

Purpose of the Study:

• To assess the feasibility, safety, and tolerability of a single-session treadmill-based backward incline walking protocol.
• To evaluate participant recruitment, adherence, safety, perceived exertion, and acceptability in individuals with chronic stroke.

Main Methods:

• A prospective, nonrandomized pilot feasibility study was conducted.
• Six individuals with chronic stroke completed three treadmill walking conditions: level, forward incline, and backward incline.
• Feasibility metrics included recruitment rate, adherence, adverse events, perceived exertion, and acceptability.

Main Results:

• The protocol demonstrated feasibility, with a 40% recruitment rate.
• All participants completed the session safely without adverse events.
• Backward incline walking resulted in the highest perceived exertion (median RPE=6) and was highly acceptable to participants.

Conclusions:

• Treadmill-based backward incline walking is a feasible, safe, and well-tolerated intervention for ambulatory individuals with chronic stroke.
• This pilot study supports progression to larger randomized trials to evaluate efficacy.
• Further research should address order effects and individualized responses to this gait training method.