title: The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report.
abstract: OBJECTIVE
  Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance, and upright mobility in an individual with chronic ISCI.
  
  
  METHODS
  A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT), 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale.
  
  
  RESULTS
  Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%.
  
  
  CONCLUSIONS
  The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted.
authors.affiliation: a Brooks Rehabilitation , Jacksonville , FL , USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Foster
authors.affiliation: a Brooks Rehabilitation , Jacksonville , FL , USA.
authors.forename: Lou
authors.initials: L
authors.lastname: DeMark
authors.affiliation: a Brooks Rehabilitation , Jacksonville , FL , USA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Spigel
authors.affiliation: a Brooks Rehabilitation , Jacksonville , FL , USA.|b Malcolm Randall VAMC , Brain Rehabilitation Research Center , Gainesville , FL , USA.|c Department of Physical Therapy , University of Florida , Gainesville , FL , USA.
authors.forename: Dorian K
authors.initials: DK
authors.lastname: Rose
authors.affiliation: a Brooks Rehabilitation , Jacksonville , FL , USA.|c Department of Physical Therapy , University of Florida , Gainesville , FL , USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Fox
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D004856:Postural Balance; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking
keywords: Backward walking; locomotion; locomotor control; rehabilitation; spinal cord injury