Effects of backward walking training on balance, gait, and functional mobility in people with multiple sclerosis: A randomized controlled study.

BACKGROUND: Backward walking training (BWT) can have a positive effect on balance, gait, and functional mobility in neurological diseases; however, the effectiveness of BWT has not been examined in multiple sclerosis (MS). Therefore, the study aimed to investigate the effects of BWT on balance, gait, and functional mobility in people with MS (PwMS). METHOD: Nineteen PwMS were randomly allocated to either the experimental group (n=10) and the control group (n=9). The experimental group received BWT in addition to conventional walking training (CWT) while the control group only received CWT. Both groups performed training three times a week for 8 weeks. Participants were assessed with the Berg Balance Scale (BBS), four square step test (FSST), activities-specific balance confidence scale (ABC), timed 25-foot walk test (T25FW), dynamic gait index (DGI), 3-meter backward walk test (3MBWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), and timed up and go test (TUG) before and after training. RESULTS: After training, both groups showed significant improvements on the T25FW, and TUG (p<0.05) while only the experimental group showed significant improvements on the BBS, FSST, ABC, DGI, 3MBWT, and MSWS-12 (p<0.05). The experimental group significantly improved more than the control group in all outcomes (p<0.05) except for the T25FW (p=0.202). CONCLUSION: BWT in addition to CWT is an effective way to improve balance, gait, and functional mobility for PwMS. These results suggest that BWT may be a potentially useful treatment approach when added to CWT in the rehabilitation of MS.

The reliability and validity of the 3-m backward walk test in people with Parkinson's disease.

BACKGROUND: People with Parkinson's disease (PwPD) lose the ability in backward walking which is an important part of mobility in daily life. The 3-m backward walk test (3MBWT) evaluates backward walking; however, its reliability and validity have not been examined in PwPD yet. AIMS: To examine (1) the test-retest reliability of the 3MBWT in PwPD; (2) the minimum detectable change in the 3MBWT times; (3) the concurrent and known-groups validity of the 3MBWT; and (4) the optimum cutoff time which best discriminates fallers from non-fallers with Parkinson's disease (PD). METHODS: This cross-sectional study included 36 PwPD and 33 healthy people. The 3MBWT was conducted with the 10-m walk test, timed up and go test, Berg Balance Scale, four square step test, activity-specific balance confidence scale, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, and Hoehn and Yahr Scale. RESULTS: The 3MBWT demonstrated excellent test-retest reliability (ICC = 0.965). The MDC of 2.13 s was determined. The 3MBWT had moderate to high correlations with the other outcome measures (correlation coefficient ranged from -0.592 to 0.858). On the 3MBWT times, there were significant differences between PwPD and healthy people, and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). A 3MBWT time of 10.31 s was found to best discriminate fallers from non-fallers with PD. CONCLUSIONS: The 3MBWT is a reliable, valid, and easy to administer outcome measure to assess backward walking performance in PwPD, indicating it to be used in practice and research.

The 3-m backward walk test: reliability and validity in ambulant people with multiple sclerosis.

To investigate: (a) the interrater and test-retest reliability of the 3-m backward walk test (3MBW) in ambulant people with multiple sclerosis (PwMS); (b) minimal detectable change (MDC); (c) concurrent and known-groups validity; and (d) the cutoff time to best discriminate fallers from nonfallers with multiple sclerosis (MS). Forty-nine PwMS and 36 healthy people were included in this cross-sectional study. The 3MBW was administered with the timed up and go test, Berg Balance Scale, four square step test, Falls Efficacy Scale-International, and Expanded Disability Status Scale. The 3MBW was simultaneously performed by two independent raters to examine the interrater reliability while was repeated after 7-10 days to examine the test-retest reliability. The 3MBW showed good interrater reliability [intraclass correlation coefficient (ICC) = 0.987-0.989] and excellent test-retest reliability (ICC = 0.854-0.889). The MDC was found to be 1.69 s. The 3MBW had moderate-to-strong correlations with the other measures. For the 3MBW, PwMS had worse performance than healthy people ( P < 0.001), whereas fallers with MS had worse performance than nonfallers with MS ( P < 0.001). The 3MBW time of 7.86 s was determined to best discriminate fallers from nonfallers with MS. The 3MBW is a reliable, simple, and easy-to-administer tool for assessing backward walking among ambulant PwMS.