ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2022 February;58(1):9-15

DOI: 10.23736/S1973-9087.21.06869-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

Yiyeop MOON ¹, Youngsook BAE ² ✉

¹ Department of Physical Therapy, Godoil Spine and Pain Hospital, Seoul, Republic of Korea; ² Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea

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.

KEY WORDS: Gait; Stroke rehabilitation; Physical and rehabilitation medicine