BACKWARD WALKING TRAINING IS AS EFFECTIVE AS OR BETTER THAN FORWARD WALKING TRAINING FOR IMPROVING WALKING SPEED AFTER STROKE: A SYSTEMATIC REVIEW.

Background: Backward walking training has gained popularity as an alternate type of training for improving walking and cardiorespiratory fitness.1 Aim: To examine the effects of backward walking training in comparison with forward walking training for improving walking after stroke. Methods: A systematic review of randomized trials was performed. Searches were conducted on AMED, Cochrane Library, EMBASE, LILACS, MEDLINE, Scielo and PEDro databases. Participants were ambulatory adults after stroke. The experimental intervention was backward walking training. Outcome data related to walking speed, cadence and stride length were combined in meta-analyses. The quality of trials was assessed by the PEDro scores, and the quality of evidence was determined according to the GRADE system. Results: Six trials (PEDro score 6), involving 156 participants, were included. The mean age of participants ranged from 50 to 69 years old. Moderate-quality evidence suggested that backward walking training is as effective or better than forward walking training for improving walking speed (MD 0.16 m/s, 95% CI 0.06 to 0.27). Effects on cadence (MD 3 steps/min, 95% CI -2 to 6) and stride length (MD 0.03 m, 95% CI -0.02 to 0.09) were very similar between interventions. Conclusion: This review provided evidence that the effect of backward walking training is similar to or better than the effect of forward walking training for improving walking speed after stroke. [ABSTRACT FROM AUTHOR]