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Case Reports
, 32 (7), 536-45

The Effects of Backward Walking Training on Balance and Mobility in an Individual With Chronic Incomplete Spinal Cord Injury: A Case Report

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Case Reports

The Effects of Backward Walking Training on Balance and Mobility in an Individual With Chronic Incomplete Spinal Cord Injury: A Case Report

Hannah Foster et al. Physiother Theory Pract.

Abstract

Background/purpose: Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance, and upright mobility in an individual with chronic ISCI.

Methods: A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT), 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale.

Results: Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%.

Conclusions: The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted.

Keywords: Backward walking; locomotion; locomotor control; rehabilitation; spinal cord injury.

Conflict of interest statement

Declaration of Interest The authors declare no conflicts of interest and no source of funding.

Figures

Figure 1
Figure 1
Intense backward walking training was performed both in the treadmill environment (A) and overground (B). Key walking rehabilitation principles were used to guide and progress the intervention in both training environments.

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