• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.76-81
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• 2010

Purpose: This study examined how the degrees of muscle activity of Rectus Femoris and Tibialis Anterior during the four phases of walking vary according to three different treadmill slopes of $0^0$, $7^0$, and $15^0$. Methods: Subjects were 14 randomly selected healthy students attending G University in Seoul, Korea who had never had articular problems with lower limb and had no difficulties walking at the time of study. Results: 1) With respect to Rectus Femoris, in every phase of both forward and backward walking, there were significant differences among all of the slope degrees (p <.05), while the activity increased with increased slope degrees in every phase of backward walking. 2) For Tibialis Anterior, only in P2 and P3 of both forward and backward walking there were significant differences in every slope (p <.05). Conclusion: Both Rectus Femoris and Tibialis Anterior were found to be more active during backward walking compared to backward walking. In addition, the activity degree of Rectus Femoris was high between the early part of two foot support phase and the early part of one foot support phase, whereas that of Tibialis Anterior was high between the early part of one foot support phase and the latter part of both foot support phase.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.21-31
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• 2017

PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.

• 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.

• 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.

• Physical Therapy Korea
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• v.23 no.3
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• pp.1-10
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• 2016

Background: Gait problems appear in most stroke patients. Commonly, stroke patients show the typical abnormal gait patterns, such as circumduction, genu recurvatum, and spastic paretic stiff-legged gait. An inclined treadmill gait exercise is good for gait problems of stroke patients. In addition, the backward walking training has been recommended in order to improve the component of the movement for the forward walking. Objects: The purpose of this study to investigated the effects of backward walking with inclined treadmill training on the gait in chronic stroke patients. Methods: A total of 30 volunteers were randomly allocated to two groups that walked on an inclined treadmill: the experimental group ($n_1=15$), which walked backward, and the control group ($n_2=15$), which walked forward. To measure the improvement of the patients' gait, a Figure of Eight Walking Test (F8W), Four Square Step Test (FSST), and Functional Gait Assessment (FGA) were performed. We also measured spatio-temporal gait variables, including gait speed, cadence, stride length, and single limb support using a three-axial wireless accelerometer. The measurements were taken before and after the experiment. The Wilcoxon signed-rank test was used to compare both groups before and after the interventions. The Mann-Whitney U test was used for the comparisons after the interventions. The statistical significance was set at ${\alpha}=.05$. Results: Before and after experiment, all dependent variables were significantly different between the two groups (p<.05). As compared to the control group, the experimental group showed more significant improvements in F8W, FSST, speed, cadence, stride length, and single limb support (p<.05); however, FGA in this group was not significantly different from the control (p>.05). Conclusion: Our results suggest that backward walking on an inclined treadmill is more effective for improving the gait of stroke patients than forward walking.

• 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.

• Korean Journal of Applied Biomechanics
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• v.18 no.3
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• pp.71-82
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• 2008

W. S. CHAE, Ground Reaction Force Charateristics During Forward and Backward Walking Over 20 Degree Ramp. Korean Journal of Sport Biomechanics, Vol. 18, No. 3, pp. 71-82, 2008. The purpose of this study was to compare GRF characteristics during forward and backward walking over 20 degree ramp. Temporal parameters, GRFs, displacement of center of pressure (DCP), and loading and decay rates were determined for each trial. The results showed that the vertical GRF in BD during RTO was significantly greater than those found in FU. This reults indicated that GRF patterns may be changed by different walking conditions and altering position of ankle, knee, and center of mass throughout the walking cycle. The DCP during $RHC_2$-LHC in antero-posterior direction for downward was smaller than the corresponding value for upward condition. It' seems that the ankle and knee joints are locked in an awkward fashion at the toe contact to compensate for imbalance. Reducing the magnitude of loading rate can be achieved by walking in the backward direction. Accordingly, the results can be a benefit if one is suffering from an impact-type injury.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.83-91
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• 2024

Purpose : This case study aimed to investigate the effects of backward walking exercises with a front-loaded bag on craniovertebral angle (CVA), craniorotational angle (CRA), and gait variables in subjects with forward head posture (FHP). Methods : Two individuals in their twenties with FHP performed backward walking exercises on a treadmill while carrying a front-loaded bag with a load equivalent to 20 % of their body weight, for 30 minutes per day, three times a week, over two weeks. CVA and CRA were measured before and after the intervention using side view photographs taken from 1.5 meters away. CVA was calculated by marking C7, the tragus of the ear, and the outer canthus of the eye, and CRA was determined using the same landmarks. Image J software was used for angle analysis, with measurements taken three times and averaged. Gait variables such as step length and cadence were recorded using a step analysis treadmill and analyzed with the software included with the equipment, with measurements taken at baseline and after the two-week intervention. Results : Both participants demonstrated notable improvements in the CVA, indicating enhanced head alignment relative to the cervical spine. There was also a marked decrease in the CRA, suggesting a reduction in rotational misalignment. Although differences were observed in gait variables, such as step length and cadence, these changes were not consistent across measurements. The results suggest that backward walking exercises with a load carried in front can positively influence postural adjustments by aligning the cervical spine in individuals with FHP. Conclusion : The findings of this case study indicate that backward walking exercises with a front-loaded bag can effectively improve cervical spine alignment in individuals with FHP. Differences were observed in gait variables, such as step length and cadence, but these changes were not consistent across measurements. Future studies should explore these effects more comprehensively and consider optimizing the exercise protocol for better therapeutic outcomes.

• PNF and Movement
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• v.9 no.2
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• pp.29-37
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• 2011

Purpose : The purpose of this study was to find out of an effect of forward, backward walking using partial weight bearing on walking of the patient with incomplete spinal cord injury. Methods : The average age, and the term of being sick of 6 patients who were selected as the subjects with incomplete spinal cord injury and who received medical attention in the National Rehabilitation Hospital, was 50.3 years old, and 10.7 months, and those were also the patients that were classified as ASIA-C or D by ASIA. The forward, backward walking using a partial weight bearing system as the research method, took total 6 weeks, 3 days per week, 3 times per day, total 45 minutes for each time(15 minutes for a time, 5 minutes for a breathing time), and the 15 minutes was used for forward walking 7.30 minutes, backward walking for 7.30 minutes, to find out before and after the test of WISCI, PCI, Walking Speed, Motor Score of Lower Limbs for the selected patients with incomplete spinal cord injury. Results : The result was showed WISCI from 17 points to 17 points that is, no change occurred at all, and PCI from $161.01{\pm}103.06$ to $74.97{\pm}58.19$, some amount of reduction that is not statistically significant(p<.05). Regarding walking speed, it increased from $24{\pm}.07m/sec$ to. $61{\pm}.35m/sec$, that is statistically significant(p<.05), and motor score of lower limbs showed statistically significant increase like from $33.17{\pm}7.08$ to $37{\pm}5.14$(P<.05). Conclusion : The 4 evaluation categories seem to have shown differences due to an insufficient number of subjects, and short test term, and it seems the more diverse task-oriented walking exercises should be studied in the coming days.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.12
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• pp.6237-6245
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• 2013

This study examined the effects of backward walking with rhythmic auditory stimulation on the gait and balance of stroke patients. Twenty-one people were divided randomly into three groups; group I(n=7, forward walking), group II(n=7, backward walking), group III(n=7, backward walking by rhythmic auditory stimulation). Each group was trained for 30 minutes 5 times per week for 3 weeks, and was evaluated using a 10m walking test, time up and go test, functional reach test, stride length and step length asymmetry ratio. As a result, the pre- to post-test measures revealed a significant effect in each group on the gait speed, gait symmetry and balance(p<.05). The walking speed, gait symmetry and balance were higher in group II (p<.05) than in group I and it was the highest in group III(p<.05). The stride length was higher in group II and group III(p<.05) than in group I. In conclusion, for stroke patients, backward walking training with rhythmic auditory stimulation is effective on the gait speed, gait symmetry and balance.