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Improved Motor Recovery, Gait Speed, and Gait Parameters Following Backwards Walking Training in an Individual Post Chronic Stroke

      Research Objectives

      To investigate the effect of a novel rehabilitation intervention of backwards walking training on gait speed and balance confidence in an individual with chronic stroke.

      Design

      Case study.

      Setting

      Ambulatory clinical research center.

      Participants

      64 year old male 19 months post-right ischemic stroke. Relevant medical history includes Patent Foramen Ovale and intermittent right osteoarthritic knee pain. Participant had been discharged from formal therapy and signed an IRB-approved Informed Consent Form to participate in a gait rehabilitation study.

      Interventions

      Sixteen sessions of gait rehabilitation that included 20 minutes of backwards walking using BWS on a treadmill followed by 20 minutes of over-ground backwards walking training. Appropriate gait kinematics were facilitated by a trained physical therapy team.

      Main Outcome Measure(s)

      Lower Extremity Fugl Meyer (LEFM), Functional Gait Assessment (FGA), 3 meter backward walk test, Activity-Specific Balance Confidence Scale (ABC) and spatial and temporal gait parameters using a GaitRite system.

      Results

      Baseline and post-training assessments revealed a 5 point increase in LEFM, a 1-point increase in FGA, an improvement in backward gait speed from 0.25 m/s to 0.40 m/s, and a 9-point improvement in the ABC Scale. GaitRite data revealed an improvement in forward gait speed from 0.45 m/s to 0.84 m/s, an increase in paretic limb step length of 21.9 cm, and in increase in paretic limb single-limb stance from 15.5% to 25.4% of the gait cycle. Results maintained at 1 month follow up.

      Conclusions

      Following 16 sessions of this novel training intervention participant demonstrated clinically significant improvement in forward gait speed, improvement in backward walking speed, increased ability to bear weight through the paretic LE as well as improved balance confidence. Backward walking training may be beneficial in the restoration of gait impairments post-stroke.

      Key Words

      Stroke, CVA, gait, rehabilitation, self-efficacy

      Disclosures

      None disclosed.