The effect of backward walking observational training on gait parameters and balance in chronic stroke: randomized controlled study.

BACKGROUND: Backward walking (BW) and action observation training may potentially help people at risk of falls. Moreover, action observation training could be a potential intervention to improve gait after a stroke. AIM: We aimed to identify the effects of BW action observational training (BWOT) on gait parameters and balance in chronic stroke patients. DESIGN: Randomized, controlled study. SETTING: Rehabilitation center. POPULATION: Twenty-four chronic stroke patients were randomly assigned to BWOT (N.=12) and landscape observational training (LOT) (N.=12) groups. METHODS: The BWOT group performed BW after watching a video of a BW, while the LOT group performed BW training after watching a video of a landscape. Both groups received traditional therapy for 5 days per week and BWOT for 3 days a week for 4 weeks. The primary and secondary outcomes were gait and balance, respectively. Static balance was measured using the 5 Times Sit-To-Stand Test (5TSTS), the center of pressure (COP) displacement, and weight distribution (WD) of the affected side. Dynamic balance was measured using the activity-specific balance confidence (ABC) scale. RESULTS: The BWOT group showed significant improvements in gait velocity (p=0.001, η2=0.470), step length (P=0.007, η2=0.313), stride lengths (P<0.002, η2=0.431), 5TSTS (P=0.021, η2=0.231), COP velocity (P=0.022, η2=0.226), length (P=0.001, η2=0.504), WD of the affected side (P=0.033, η2=0.193), and ABC score (P=0.023, η2=0.226) than the LOT group. CONCLUSIONS: The 4-week BWOT training program significantly improved the gait parameters and static and dynamic balance in stroke patients. CLINICAL REHABILITATION IMPACT: BWOT is an accessible and effective method of rehabilitation training that can also be applied to conventional therapy as a useful method for improving the gait and balance after stroke.

Backward walking observational training improves gait ability in patients with chronic stroke: randomised controlled pilot study.

Backward walking has a positive effect on gait ability. Action observational training is an effective treatment method for stroke neurological disorders. This randomised comparator-controlled pilot study aimed to evaluate the feasibility of backward walking observational training on the gait ability of chronic stroke patients. Fourteen chronic stroke participants were randomly allocated to the experimental group (backward walking observation; n = 7) and control group (landscape observation; n = 7). Both groups performed conventional therapy 5 days/week; then the backward walking observation and landscape observation + backward walking training groups performed the observational training 3 days/week for 4 weeks. The primary outcome was measured dynamic gait index, 10-m walking test, and timed up and go test time. Both groups showed significant increases in dynamic gait index, 10-m walking test, and timed up and go test time. The experimental group showed more significant improvements in dynamic gait index (P = 0.04, η = 0.336), 10-m walking test (P = 0.04, η = 0.306), and timed up and go test time (P = 0.03, η = 0.334) than the control group. This pilot study demonstrated that conventional therapy with backward walking observational training improves gait ability. Our findings suggest that observing an action may have a positive effect on chronic stroke patients.Trial Registration Clinical Trials: KCT0003098.