Backward walking training is as effective as or better than forward walking training for improving walking speed after stroke: a systematic review with meta-analysis.
Study Goal
The researchers aimed to determine whether backward walking training is comparable or superior to forward walking training for improving walking speed, cadence, and stride length in stroke survivors, and whether combining both enhances benefits.
Results Summary
Backward walking training was slightly better than forward walking for improving walking speed but showed negligible additional benefits when combined with forward walking. Results for cadence and stride length were imprecise, and maintenance of effects post-intervention remains uncertain.
Population
Adults who have had a stroke.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
backward walking training | increase | walking speed | adults following stroke | MD 0.16 m/s, 95% CI 0.06 to 0.27 | is similar as or better than that of forward walking training for improving | #1 |
backward walking training | no change | cadence | adults following stroke | very imprecise | results for | #2 |
backward walking training | no change | stride length | adults following stroke | very imprecise | results for | #3 |
addition of backward walking training to forward walking training | increase | walking speed | adults following stroke | MD 0.03 m/s, 95% CI 0.01 to 0.04 | provided negligible effects on | #4 |
addition of backward walking training to forward walking training | increase | cadence | adults following stroke | MD 5 steps/min, 95% CI 1 to 10 | provided negligible effects on | #5 |
addition of backward walking training to forward walking training | no change | stride length | adults following stroke | MD 0.04 m, 95% CI -0.01 to 0.09 | provided negligible effects on | #6 |
backward walking training | no change | walking speed, cadence, and stride length | adults following stroke | remains uncertain | Maintenance of effects beyond the intervention period remains uncertain | #7 |
OBJECTIVE: In people who have had stroke, are the effects of backward walking comparable with forward walking for improving walking (i.e. speed, cadence, and stride length)? Does the addition of backward walking to forward walking help improve the benefits of forward walking? Are any benefits maintained beyond intervention? METHODS: A systematic review of randomized trials, with adults following stroke, was developed. The intervention of interest was backward walking training, delivered either as a solo intervention or in combination with forward walking training. The outcome measures of interest were walking speed, cadence, and stride length. RESULTS: The effect of backward walking training is similar as or better than that of forward walking training for improving walking speed (MD 0.16 m/s, 95% CI 0.06 to 0.27), but results for cadence and stride length were very imprecise. The addition of backward walking training to forward walking training provided negligible effects on walking speed (MD 0.03 m/s, 95% CI 0.01 to 0.04), cadence (MD 5 steps/min, 95% CI 1 to 10), and stride length (MD 0.04 m, 95% CI -0.01 to 0.09). Maintenance of effects beyond the intervention period remains uncertain. CONCLUSIONS: This review provided moderate-quality evidence that backward walking training is slightly better than forward walking training for improving walking speed after stroke, but not when it is additional to forward walking training. Large and well-designed trials are warranted to strengthen the evidence regarding backward walking training, especially in the subacute phase after stroke.