• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.77-85
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• 2014

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

• Journal of the Ergonomics Society of Korea
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• v.20 no.2
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• pp.47-57
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• 2001

To simulate an actual slip to measure floor slipperiness, slip resistance testers simulate slip in only forward direction because forward slip in the landing phase was found to be the most important factor for loss of balance. Backward slip in the take off phase was possible but was excluded in the friction test protocol because it was not dangerous. However, backward slip was tested in the friction test protocol without any theoretical background of the significance in generating dangerous slips and falls and was proven to be as good as forward slip in measuring floor slipperiness. Therefore, this study was designed to investigate the significance of backward slip in generating dangerous slips and falls with different combinations of floor and shoe sole. The results showed different tendency of backward slip in take off phase being significant in generating dangerous slips and falls because backward slip in the takeoff phase affected gait pattern disturbances seriously. resulted in dangerous falls. Fast toe velocity increased the severity of backward slip and confirmed the significance of backward slip in generating dangerous slips and falls. As a result, this study recommends the utilization of backward slip in the measurement of floor slipperiness.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.53-60
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• 2018

PURPOSE: This study aimed to identify the effect of a backward walking exercise using a mirror on balance and gait in patients with stroke. METHODS: Twenty subjects with post-stroke hemiparesis volunteered to participate in this study. The experimental and control groups performed backward walking exercise plus conventional therapy or conventional physical therapy, respectively, for 6 weeks. Assessment instruments included the Berg Balance Scale (BBS), timed up and go test (TUG), and 10-m walking test (10MWT). Evaluation was performed before and after the 6-week training period. We conducted a paired t-test to compare the within-group changes before and after the intervention. An independent t-test was used to compare between-group differences. The statistical significance level was set at ${\alpha}=.05$ for all variables. RESULTS: The experimental group showed a significant within-group change in the BBS, TUG, and 10MWT (p<.05). The control group also showed a significant change (p<.05). A significant difference was observed between the experimental and control groups with regard to changes in the BBS, TUG, and 10MWT results after the interventions (p<.05). CONCLUSION: This study demonstrated that backward walking exercise using a mirror may be valuable for future research. Further studies with a wider range of pathology and longer experiment duration are required to validate the results of the present study.

• PNF and Movement
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• v.11 no.2
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• pp.103-110
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• 2013

Purpose : The aim of study was to assess the effect of backward walking combined with body weight supported treadmill training for patients with spinal cord injury. Methods : Forced vital capacity(FVC), forced expiratory volume at one second(FEV1), peak expiratory flow(PEF) and FEV1/FVC ratio(FER) were measured with a spirometer for on subject of T12 spinal cord injury. 10 meter walking test(10MWT), timed up & go test(TUG) and 6-Minute walking test(6MWT) were the measured. Intervention consisted of backward walking combined with body weight supported treadmill training five times a week for 12 weeks. Results : The date of 10MWT, TUG, 6MWT were improved. Furthermore, the date of PEF, FEV1, FVC, FER showed a improvement. Conclusion : Backward walking combined with body weight supported treadmill training may be a better and more effective method for gait performance and respiratory on incomplete spinal cord injury.

• PNF and Movement
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• v.7 no.4
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• pp.31-36
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• 2009

Many daily activities require people to complete a motor task while walking. Substantial gait decrements during simultaneous attention to a variety of cognitive tasks have been shown by a group of severely injured neurological patients of mixed etiology. And previous studies have shown that the attentional load of a walking-associated task increased with its level of difficulty. The purpose of this study was to analyze subjects' gait changes are affected by the effects of arithmetic task difficulty and performance level. Participants performed a walking task alone, three different Arithmetic tasks while seated, and among them, two kinds of the simillar Arithmetic tasks in combination with walking. Reaction time and accuracy were recorded for two of the Arithmetic tasks. The mean values of the gait were measured using a Timed Up and Go test among 11 with post-stroke patients while walking with and without forward counting (WFC) and backward counting(WBC).There was significant Arithmetic Task Difficulty level between the 10-forward counting task condition(FC) and the 10-backward counting task condition(BC)(p=0.008). The mean values of T.U.G time were significantly higher under backward counting dual-task condition than during a simple walking task(p=0.009) and WFC(p=0.009). The change in T.U.G time during WFC was higher when compared with the change during a simple walking, but there was no significant difference (p=0.246). This study suggesting that a high interference could be linked with a high level of difficulty, whereas adaptive task enabled participants to perfectly share their attention between two concurrent tasks. Future research should determine whether dual task training can reduce gait decrements in dual task situations in people after stroke. And the dual-task-based exercise program is feasible and beneficial for improving walking ability in subjects with stroke.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.135-144
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• 2021

Purpose : The purpose of this study was to investigate the effect of 2 weeks of backward walking exercise (BWE) on cervical angle and gait parameters in college students with forward head posture. Methods : Fifteen subjects participated in the experiment. All the participants had a craniovertebral angle (CVA) of 55 degrees or less. The purpose of the study was explained to all the subjects prior to participation, and volunteered to take part in the study. A camera capable of taking pictures of the lateral plane was installed at a distance of 1.5 meters from each subject. Images of forward head posture were obtained before and after performing the BWE, and the CVA and craniorotational angle (CRA) were compared pre- versus post exercise. Foot pressure and gait parameters (step length of left and right, stride length, stance of left and right, swing of left and right, step time of left and right, and stride time) were measured using a rehabilitation treadmill. The subjects performed the BWE for 2 weeks. The exercise program consisted of a 5-minute warm-up exercise, 20-minute main exercise, and 5-minute cool-down exercise. In the main exercise, the treadmill speed was set to 2.4 km/h in the first week and 3.4 km/h in the second week. A paired t test was used to compare the CVA and CRA and gait parameters before and after the exercise. Results : Comparison of the CVA and CRA before and after the BWE revealed a significant difference post exercise, with a marked improvement in forward head posture after the exercise (p<.05). Conclusion : Based on the results of this study, the BWE is considered to be an effective exercise for the forward head posture. Also, additional research is needed to shed light on the impact of the BWE on gait parameters.

• Journal of Digital Convergence
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• v.13 no.1
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• pp.367-373
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• 2015

The purpose of this study was to examine the effect of backward walking training on the balance capability(Functional Gait Assessment; FGA, Timed Up & Go Test; TUG) and gait performance(10 meter Walking Test; 10 mWT) of stroke patients. Eighteen with stroke patients were randomly allocated to an experimental and contral group of nine patients each. both groups received general neurorehabilitative physical therapy for 45 minutes per day 5 times per week during 4 weeks. The experimental group also performed additional backward walking training for 20 minutes per day 3 times per week during 4 weeks. There were signicantly increase by backward walking training in outcome of the balance capability from the FGA was increase from $17.67{\pm}1.00scores$ to $19.22{\pm}1.00scores$(p<.05), TUG was decrease from $26.45{\pm}1.37sec$ to $23.28{\pm}1.35sec$(p<.05) and 10 mWT was decreased from $21.74{\pm}1.35sec$ to $18.33{\pm}1.10sec$ (p<.05). These result suggest that backward walking training for stroke patients is effective in improving balance capability(FGA, TUG) and gait performance(10 mWT).

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.241-250
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• 2022

Purpose : The purpose of this study was to investigate the effect of backward walking exercise on changes in the cervical angle and gait parameters in subjects with moderate forward head posture. Methods : Four subjects were selected for this study. In particular, subjects with an average of 43 subjects with moderate craniovertebral angles were selected as the criteria for subject selection. The exercise program consisted of a 5 minutes warm-up exercise, 20 minutes main exercise, and 5 minutes cool-down exercise. In the main exercise, the treadmill speed was 2.5 km/h for men, 2.0 km/h for women in the first week, from the 2nd week to the 4th week, it was increased by 0.5 km/h every week. Results : Craniovertebral angle increased by 2.06±2.46 ° before and after the backward walking exercise, and craniorotational angle decreased by -1.69±3.33 ° before and after exercise. As for the gait parameters, in the amount of change before and after the backward walking exercise, the left foot pressure was 4.58±5.70 % from front to back and the right foot pressure was 5.08±3.06 % from front to back. The left step length and right step length showed a change of -.33±4.43 cm and -2.08±7.26 cm, respectively. stride length showed a change of -2.59±11.18 cm. The left and right stance phase showed a change of -1.02±2.03 % and -1.23±1.54 %, respectively. The left and right swing phase showed changes of 1.02±2.03 % and 1.22±1.53 %, respectively. The left and right step times were -.01±.06 sec and -.02±.12 sec, respectively. The stride time showed a change of -.03±.18 sec. Conclusion : Changes in cervical angle and gait parameters were confirmed by performing backward walking exercise for subjects with moderate forward head posture for 4 weeks. Therefore, additional research should be conducted based on this case study.

• Physical Therapy Rehabilitation Science
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• v.7 no.2
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• pp.83-87
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• 2018

Objective: The purpose of this study was to investigate the relationship between heart rate (HR), self-awareness of exercise intensity (rating of perceived exertion, RPE), and 5-meter walk test (5MWT) of persons affected by stroke during backward walking according to the preferred stride frequency (PSF), PSF+3 and PSF+6 conditions. Design: Cross-sectional study. Methods: A total of 11 persons with stroke (9 males, 2 females) participated voluntarily. All patients underwent backward walking under the PSF, PSF+3, and PSF+6 conditions in underwater and ground environments, and each condition was performed for 5 minutes. The HR, RPE, and walking speeds were measured during walking, and the measured values from underwater and ground environments were compared. Results: The HR and RPE in the ground environment were significantly increased (p<0.05), and although the 5MWT showed an increase in speed, it was not significant. The HR and RPE in the underwater environment were also significantly increased (p<0.05), however, although the 5MWT results was increased, it was not significant. The HR and RPE were significantly increased in the PSF+6 condition (p<0.05). Conclusions: The results of this study showed that backward gait training underwater can provide an appropriate exercise intensity for stroke survivors and suggests that exercises performed in an underwater environment is more effective compared to the ground environment.

• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.45-50
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• 2022

Purpose: The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p<0.05), and stride time was significantly greater (p<0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p>0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p<0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p<0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p>0.05). Conclusion: A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.