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Comparison of forward versus backward walking using body weight supported treadmill training in an individual with a spinal cord injury: a single subject design.

Physiotherapy theory and practice
January 1, 2014
Gabriele Moriello et al. (6 authors)
Case ReportsJournal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to compare the effects of backward walking (BW) and forward walking (FW) using body weight supported treadmill training (BWSTT) in an individual with quadriparesis due to spinal cord injury (SCI).

Results Summary

Both BW and FW training led to similar improvements in gait parameters, timed 4-meter walk, 6-minute walk test, tandem balance, and aerobic endurance. BW training showed greater improvement in the 5-repetition sit-to-stand test (STST) compared to FW.

Population

A 57-year-old male with incomplete C3-C6 spinal cord injury.

Effective Dosage

Biweekly sessions (frequency), 3 weeks per phase (duration).

Duration

18 weeks total (ABABAB design, 3 weeks per phase).

Interactions

None mentioned

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
forward walking training using body weight supported treadmill training
increase
gait parameters
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#1
backward walking training using body weight supported treadmill training
increase
gait parameters
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#2
forward walking training using body weight supported treadmill training
increase
timed 4-meter walk
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#3
backward walking training using body weight supported treadmill training
increase
timed 4-meter walk
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#4
forward walking training using body weight supported treadmill training
increase
6-minute walk test
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#5
backward walking training using body weight supported treadmill training
increase
6-minute walk test
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#6
forward walking training using body weight supported treadmill training
increase
tandem balance
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#7
backward walking training using body weight supported treadmill training
increase
tandem balance
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#8
forward walking training using body weight supported treadmill training
increase
aerobic endurance
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#9
backward walking training using body weight supported treadmill training
increase
aerobic endurance
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
improvements
#10
backward walking training using body weight supported treadmill training
increase
5-repetition sit-to-stand test
an individual with quadriparesis (incomplete C3-C6 spinal cord injury)
-
resulted in greater improvements
#11
backward walking training
increase
5-repetition sit-to-stand test
this individual
-
resulting in improved ability to perform
#12
Abstract

PURPOSE/HYPOTHESIS: Body weight supported treadmill training (BWSTT) is a task-specific intervention that promotes functional locomotion. There is no research evaluating the effect of backward walking (BW) using BWSTT in individuals with spinal cord injury (SCI). The purpose of this single subject design was to examine the differences between forward walking (FW) and BW training using BWSTT in an individual with quadriparesis. METHODS: The participant was a 57-year-old male with incomplete C3-C6 SCI. An ABABAB design (A = BW; B = FW; each phase = 3 weeks of biweekly sessions) was utilized. Outcome measures included: gait parameters; a timed 4-meter walk; the 5-repetition sit-to-stand test (STST); tandem stance time; and 6-minute walk test (6MWT). Data was analyzed with split level method of trend estimation. RESULTS: Improvements in gait parameters, on the timed 4-meter walk, 6MWT, tandem balance and aerobic endurance were similar with FW and BW training. The only difference between FW and BW training was that BW training resulted in greater improvements in the STST. CONCLUSIONS: The results of this study suggest that in this individual backward walking training was advantageous, resulting in improved ability to perform the 5-repetition STST. It is suspected that these changes can be attributed to the differences in muscle activation and task difficulty between FW and BW.

Medical Subject Headings (MeSH)
Biomechanical PhenomenaBody WeightCervical VertebraeExercise TestExercise TherapyGaitHumansMaleMiddle AgedMuscle ContractionMuscle StrengthMuscle, SkeletalPsychomotor PerformanceQuadriplegiaRecovery of FunctionSpinal Cord InjuriesTime FactorsTreatment OutcomeWalkingWeight-Bearing
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality65/10
Citation Metrics
Total Citations11
Citations/Year1.0
Relative Citation Ratio0.67
NIH Percentile35.9%
Research Impact Scores
APT Score0.25
Weight Score1.38
Normalized Score0.63
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