Prefrontal hemodynamics during forward and backward walking, with and without a cognitive task, in people with multiple sclerosis.
Yana Kupchenko, Sapir Dreyer-Alster, Kim-Charline Broscheid and 1 others
PMID 36940180WHAT IT FOUND
Backward walking increased prefrontal cortex activity in people with MS, similar to adding a cognitive task to forward walking.
This suggests backward walking is cognitively demanding, potentially useful for dual-task training, though no clinical outcomes were measured.
Key findings
01Walking backward increased prefrontal cortex oxygenation compared to walking forward in both people with MS and healthy controls, particularly in the frontopolar and frontal eye field areas.
02Adding a cognitive task to forward walking also increased prefrontal cortex oxygenation and slowed walking speed in both groups, but the brain activity pattern was similar between people with MS and controls.
03People with MS walked significantly slower than healthy controls in all conditions, and backward walking was the slowest condition for both groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was observational and did not test whether backward walking improves clinical outcomes like balance, gait, or cognition. The sample size was small and convenience-sampled, with no power calculation. Only people with relapsing-remitting MS and mild disability (EDSS median 3.0) who could walk without aids were included, limiting generalizability to those with progressive MS or greater disability. The fNIRS cap was a single size, which may have affected measurement accuracy. The study did not measure brain lesion load, which could influence PFC activity.
Declared interests
None declared in the provided text.
The easy way to misread this
Do not conclude that backward walking improves cognition or gait. This study measured brain activity (hemodynamics) as a proxy for cognitive load, not clinical outcomes. The finding that PFC activity increases during backward walking means it is mentally demanding, not that it is therapeutic.