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Clinical application of backward walking training to improve walking function, balance, and fall-risk in acute stroke: a case series.

Topics in stroke rehabilitation
October 1, 2019
Louis DeMark et al. (5 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to determine the effects of adding backward walking training to standard inpatient rehabilitation on balance, walking ability, and fall-risk in adults early after stroke.

Results Summary

All eight patients showed improvements in balance, walking ability, and fall-risk, with clinically meaningful increases in forward walking speed. Four participants exceeded fall-risk cut-off scores for balance-related outcomes.

Population

Adults <2 weeks post-stroke with a broad range of lesion locations and physical sequelae (average age 66.5 ± 11.7 years, 5 male, 6 right hemiparesis).

Effective Dosage

20 minutes of over-ground backward walking per session, 10 daily sessions.

Duration

10 days

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Backward walking (BW) training program
increase
all outcomes
patients with first-time stroke
-
demonstrated improvements
#1
Backward walking (BW) training program
increase
forward walking speed
patients with first-time stroke
-
clinically meaningful increase
#2
Backward walking (BW) training program
increase
balance and walking function
patients with first-time stroke
-
significant gains
#3
Abstract

Background: With limited inpatient rehabilitation (IR) length of stays for patients post-stroke, it is critical to maximize the effectiveness of interventions to address their balance and gait speed deficits. Backward walking (BW) is an emerging training approach; however, its application to patient populations consistent with those in IR is limited. Objectives: To describe the effects of an additional BW training program to standard IR care on balance, walking ability and fall-risk in a heterogenic caseload of adults <2 weeks post-stroke with a broad range of lesion locations and physical sequelae. Methods: Eight patients with first-time stroke (5 male; average age 66.5 ± 11.7 years; average stroke onset 7.6 ± 1.6 days; 6 right hemiparesis) participated in 10-daily sessions that included 20 min of over ground BW training for each session, in addition to standard IR. Standard outcome measures were used to assess balance, walking ability and fall-risk at admission and post-intervention. Results: All eight patients demonstrated improvements in all outcomes with a clinically meaningful increase in forward walking speed, as measured by 10MWT. Four participants exceeded fall-risk cut-off scores for all balance-related outcome measures. Conclusions: In a diverse patient population early after stroke, individuals successfully participated in an additional BW training program. Despite the patients' acuity and severe impairments in walking, significant gains in balance and walking function were noted. This program may be useful in improving outcomes with patient characteristics commonly seen in IR.

Medical Subject Headings (MeSH)
Accidental FallsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPostural BalanceStrokeStroke RehabilitationTreatment OutcomeWalkingWalking Speed
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality70/10
Citation Metrics
Total Citations7
Citations/Year1.2
Relative Citation Ratio0.67
NIH Percentile35.7%
Research Impact Scores
APT Score0.50
Weight Score1.94
Normalized Score0.68
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