Elsevier

Gait & Posture

Volume 52, February 2017, Pages 363-366
Gait & Posture

Full length article
Spatial and temporal gait characteristics of elderly individuals during backward and forward walking with shoes and barefoot

https://doi.org/10.1016/j.gaitpost.2016.12.007Get rights and content

Highlights

  • Spatio-temporal characteristics of BW and FW while barefoot versus wearing shoes at a comfortable walking speed among elderly independent walker were investigated.

  • Wearing shoes affects backward versus forward walking differently.

  • Better performance was demonstrated walking backwards while barefoot as reflected in faster gait velocity and increased cadence, along with lower DLS.

  • Assessment of the spatio-temporal parameters of walking barefoot and with shoes during FW and BW can contribute to our understanding of the ability of elderly individuals to adapt to changing walking conditions.

Abstract

Backward walking (BW) is an inherent component of mobility and function in daily activities, particularly indoors, when it is more likely that a person is barefoot. No studies to date have compared the spatio-temporal characteristics of BW with and without shoes in elderly individuals.

This study compared spatio-temporal measures of BW and forward walking (FW) among elderly individuals while barefoot or wearing shoes. Forty-seven elderly individuals (13 men and 34 women, 76.7 ± 7.7 years of age) were evaluated. Participants were requested to walk at a comfortable, self-selected pace across the GAITRite® walkway for three trials under each of four conditions: walking forward (FW) and BW wearing their own comfortable low-heeled walking shoes and FW and BW walking without shoes. Gait speed, stride length and cadence were significantly reduced in BW versus FW, with an increase in double limb support (DLS), both with and without shoes. Barefoot BW resulted in significantly increased gait speed and cadence, and decreased DLS compared to BW with shoes. BW stride length was not affected by footwear. While barefoot FW was also associated with a significant increase in cadence and decrease in DLS time compared to walking with shoes, it decreased stride length and had no detrimental effect on gait speed. Assessment of the spatio-temporal parameters of walking barefoot and with shoes during FW and BW can contribute to our understanding of the ability of elderly individuals to adapt to changing walking conditions, and should be included in the assessment of functional mobility of elderly individuals.

Section snippets

Background

Backward walking (BW) is an inherent component of mobility and function in daily activities, such as opening a door, backing away from a sink or stepping back from a curb as a swiftly moving bus passes [1]. BW has some benefits beyond those provided by forward walking (FW) alone [2], as it imposes less biomechanical strain on the knees [3], [4]. Accordingly, BW has been used as an intervention tool for a variety of orthopedic and neurological pathologies, such as stroke and knee joint

Subjects

Elderly individuals who met the following inclusion criteria were recruited for this study: age at least 65 years; able to walk 50 m without an assistive device. Exclusion criteria were: fracture of the lower limb in the past two years; deformation or structural changes in the foot (such as toe amputation, hammer toe, etc.); foot ulcers due to illness (such as diabetes); blindness or severe visual dysfunction not corrected with glasses or contact lenses; neurological pathologies; unstable heart

Results

Forty-seven elderly individuals (13 men and 34 women, 76.7 ± 7.7 years of age) were included in the study. Demographic characteristics, results of the ABC questionnaire, MoCA test and the performance based clinical measures of balance are presented in Table 1. Cognitive status of the subjects was in the normal range for their age. The mean BBS and TUG values indicated no balance deficits. Results (mean ± SD) of the spatio-temporal outcome measures in each of the four walking conditions are presented

Discussion

This is the first study to compare the spatio-temporal gait characteristics of BW while walking with and without shoes. It further examined whether similar differences resulting from the removal of footwear are observed during FW. The results indicate that wearing shoes has a different effect on forward versus backward walking. Wearing shoes while FW presented a significantly increased stride length and DLS with decreased cadence, with no change in gait velocity compare to barefoot FW. Similar

Conclusion

This study investigated the spatio-temporal characteristics of BW and FW while barefoot versus wearing shoes at a comfortable walking speed among elderly independent walkers. Wearing shoes affects backward versus forward walking differently. Better performance was demonstrated walking backwards while barefoot as reflected in faster gait velocity and increased cadence, along with lower DLS. The findings of this study extend the available information on footwear-related differences in

Conflict of interest

The authors have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.

References (35)

  • Y.R. Yang et al.

    Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial

    Clin. Rehabil.

    (2005)
  • R. Grasso et al.

    Motor patterns for human gait: backward versus forward locomotion

    J. Neurophysiol.

    (1998)
  • D.A. Winter et al.

    Backward walking: a simple reversal of forward walking?

    J. Mot. Behav.

    (1989)
  • J. Dufek

    Backward walking: a possible active exercise for low back pain reduction and enhanced function in athletes

    J. Exerc. Physiol.

    (2011)
  • W.Y. Hao et al.

    Backward walking training improves balance in school-aged boys. BMC Sports Science

    Med. Rehabil.

    (2011)
  • Y. Laufer

    Age‐and gender‐related changes in the temporal‐spatial characteristics of forwards and backwards gaits

    Physiother. Res. Int.

    (2003)
  • Y. Laufer

    Effect of age on characteristics of forward and backward gait at preferred and accelerated walking speed

    J. Gerontol. Series A

    (2005)
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