Immediate Effects of Backward Incline Walking on Gait in Chronic Stroke Survivors: A Feasibility Study

Background and/or Objectives: Restoring normal gait function remains a major clinical challenge in post-stroke rehabilitation. Emerging evidence indicates that backward walking training is better than forward walking to improve gait speed in stroke survivors. Hence, it is likely that backward incline walking could provide additional challenge and benefit post-stroke rehabilitation, but this remains to be tested. Therefore, this study investigated the immediate effects of backward incline walking on gait outcomes in individuals with chronic stroke.

Design: Prospective Nonrandomized Feasibility Study

Setting : Clinical Assessment in Human Dynamic Laboratory

Participants : Three stroke survivors (mean age 68±5; mean chronicity 10±48 months) completed pre- and post-assessments after 3 training interventions.

Interventions: Level walking, forward incline walking, and backward incline walking.

Main Outcome Measures: Gait speed, cadence, step timing average as a percentage of the gait cycle were assessed at self-selected and fast speeds using TEKSCAN. Perceived exertions were measured using the Borg scale (1-10).

Results: Gait speed showed improvements across conditions, with the highest values observed after backward incline walking (F = 16.5, p = 0.03, η² = 0.85). At fast speed, backward incline walking also improved the average single-leg stance (t = 20.7, p = 0.05, Cohen's d = 14.6). Borg exertion ratings progressively increased across conditions, with the highest values observed during backward incline walking (F = 12.9, p = 0.04, η² = 0.81).

Conclusions: The preliminary results suggest that backward incline walking is a feasible method to target post-stroke gait impairments. Further studies are needed to fully explore its therapeutic benefits and long-term effects.