title: Comparison of forward versus backward walking using body weight supported treadmill training in an individual with a spinal cord injury: a single subject design.
abstract: OBJECTIVE
  Body weight supported treadmill training (BWSTT) is a task-specific intervention that promotes functional locomotion. There is no research evaluating the effect of backward walking (BW) using BWSTT in individuals with spinal cord injury (SCI). The purpose of this single subject design was to examine the differences between forward walking (FW) and BW training using BWSTT in an individual with quadriparesis.
  
  
  METHODS
  The participant was a 57-year-old male with incomplete C3-C6 SCI. An ABABAB design (A = BW; B = FW; each phase = 3 weeks of biweekly sessions) was utilized. Outcome measures included: gait parameters; a timed 4-meter walk; the 5-repetition sit-to-stand test (STST); tandem stance time; and 6-minute walk test (6MWT). Data was analyzed with split level method of trend estimation.
  
  
  RESULTS
  Improvements in gait parameters, on the timed 4-meter walk, 6MWT, tandem balance and aerobic endurance were similar with FW and BW training. The only difference between FW and BW training was that BW training resulted in greater improvements in the STST.
  
  
  CONCLUSIONS
  The results of this study suggest that in this individual backward walking training was advantageous, resulting in improved ability to perform the 5-repetition STST. It is suspected that these changes can be attributed to the differences in muscle activation and task difficulty between FW and BW.
authors.affiliation: Department of Physical Therapy, The Sage Colleges , Troy, NY , USA.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Moriello
authors.forename: Neeti
authors.initials: N
authors.lastname: Pathare
authors.forename: Cono
authors.initials: C
authors.lastname: Cirone
authors.forename: Danielle
authors.initials: D
authors.lastname: Pastore
authors.forename: Dacia
authors.initials: D
authors.lastname: Shears
authors.forename: Sahira
authors.initials: S
authors.lastname: Sulehri
mesh_terms: D001696:Biomechanical Phenomena; D001835:Body Weight; D002574:Cervical Vertebrae / Q000293:injuries* / Q000503:physiopathology; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation*; D011597:Psychomotor Performance; D011782:Quadriplegia / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing