Effect of backward walking training on foot biomechanics, balance and kinesiophobia in elderly individuals: Randomized controlled study

This study was planned to investigate the effect of BWT on AJPS, foot posture and functions, lower extremity muscle strength, balance and mobility ability, kinesiophobia status and fall incidence in older adults living in nursing homes. Our study was completed with 52 individuals who were randomized to the GDY and IDYE groups. Our study was carried out with 52 individuals who were randomized to the GDYE and IDYE groups. In the evaluation of individuals, SMMT, TUGT, 10-mWT, 3-mBWT, 6MWT, AJPS Assessment, FPI, FFI, Sit-Stand Chair Test, TKS and FES-I were used. In our study, one group was given BWT for 50 minutes, two days a week for eight weeks, while the other group was given FWT for equal duration and frequency. When the average scores obtained from all tests and scales after the training were examined between the groups, cognitive status (p = 0.014), ABEPH [10º DF (left p = 0.005)], lower extremity muscle strength (p<0.001), balance and mobility ability (p =0.003), kinesiophobia level (p<0.001), forward (p=0.003) and backward walking speed (p<0.001), functional exercise capacity (p=0.018), BWT was found to be in better condition than FWT. When the differences obtained from the pre- and post-training values were examined between the two groups, it was observed that, BWT was found to be more effective on AJPS [10⁰ DF (right p=0.021; left p=0.007), 10⁰ PF (right p=0.014)], lower extremity muscle strength (p<0.001), balance and mobility ability (p<0.001), kinesiophobia level (p<0.001), fear of falling (p=0.019), 10-mWT and 3-mBWT speed (p<0.001), and functional exercise capacity (p<0.001) than FWT. However, the trainings provided were not superior to each other in terms of their effects on cognitive status (p=0.104), AJPS [10⁰ PF (right p=0.653), 20⁰ PF (right p=0.104; left p=0.755)], all criteria of FPI and the incidence of falls. As a result of our study, considering that BWT is more effective on AJPS, lower extremity muscle strength, balance and mobility ability, kinesiophobia level, walking speed, fear of falling and functional exercise capacity in older adults living in nursing homes, it should be primarily recommended to include BWT in geriatric rehabilitation plan. In addition, in future studies, evaluations should be repeated at appropriate time intervals to determine whether the gains obtained from BWT continue in the long term.