Backward Walking Styles and Impact on Spatiotemporal Gait Characteristics.

Forward walking (FW) is a common balance assessment tool. However, its sensitivity is limited by the ceiling effect. Reverse gait, such as backward walking (BW), has been reported to have more advantages than FW for balance assessment. Three factors related to postural instability (i.e., increased speeds, restricted arm swing, and reduced visual feedback) during BW were investigated to determine BW conditions that have the potential to predict falls. Three-dimensional analyses were used to analyze seven walking conditions. FW and BW at self-selected and fast speeds were analyzed to identify the effects of speed. Walking with normal arm swings, crossed arms, and abducted arms during BW was tested to determine the effects of arm position. BW with closed and open eyes was compared to investigate the effects of visual feedback. BW had a significantly shorter step length than FW at high speeds. When the arms were abducted, the stance phase (%) was significantly lower compared to when arms were crossed during BW. Moreover, BW with closed eyes revealed significantly higher mediolateral center of mass (COM) displacements than with open eyes. We observed that BW with fast speeds, a crossed arm position, and closed eyes has the potential to help assess fall risk because it requires higher balance ability through spatiotemporal and COM adjustment.