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 interve ntion 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. LOCATION 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.