Comparison of forward walking and backward walking in stroke hemiplegia patients focusing on the paretic side.
Misato Makino, Akiyoshi Takami, Atsushi Oda
PMID 28265136WHAT IT FOUND
Backward walking was slower and had shorter strides than forward walking.
Hip extension and ankle push-off forces were significantly reduced. This suggests backward walking requires different mechanics, but the small sample size limits how broadly this applies to stroke recovery.
Key findings
01Walking speed and stride length were significantly lower during backward walking compared to forward walking.
02Peak hip joint extension angle was significantly lower in backward walking, indicating a narrower range of motion.
03Peak ankle joint plantar flexion moment was significantly lower in backward walking, suggesting reduced propulsion from the ankle.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only nine participants were studied, which is a very small sample size and limits the generalizability of the findings. Trunk and pelvic movements were not analyzed, so the compensatory strategies patients used to walk backward are unknown. Backward walking is an unfamiliar task, so performance may reflect learning effects or caution rather than pure biomechanical capacity. Participants walked at a self-selected speed, so differences in effort or strategy between the two conditions cannot be fully controlled.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume backward walking is an effective method to improve forward walking speed or ankle push-off power. The study shows backward walking generates significantly less ankle propulsion than forward walking, and the small sample size means these mechanics may not represent all stroke patients.