Wang Junjie, Xu Jian, An Ruopeng
Department of Physical Education, Dalian University of Technology, Dalian, China.
Department of Physical Education, Dalian University of Technology, Dalian, China.
Gait Posture. 2019 Feb;68:466-475. doi: 10.1016/j.gaitpost.2019.01.002. Epub 2019 Jan 3.
Backward walking (BW) training is thought to impact balance performance through improving motor system proprioception and gait characteristic, but relevant evidence remains sparse and inconclusive.
This study systematically reviewed and quantified the scientific evidence regarding the effectiveness of BW training on balance performance.
Keyword and reference search on BW training interventions was conducted in six electronic databases (PubMed, Web of science, SPORTDiscus, CINAHL, Cochrane Library, and CNKI) for peer-reviewed articles published till November 2017. A standardized form was used to extract data from each selected article that met the pre-specified eligibility criteria. Meta-analysis was conducted to estimate the pooled effects of BW training on balance performance measures.
Eleven studies (nine randomized controlled trials and two pre-post studies) met the eligibility criteria and were included in the review. All studies reported some beneficial effects of BW training on balance performance. Compared to control, BW training was associated with a reduction in overall stability index score by 0.99 (95% CI = 0.37, 1.61; I = 0.0%; fixed-effect model), medial-lateral stability index score by 0.95 (95% CI = 0.34, 1.57; I = 0.0%; fixed-effect model), and anterior-posterior stability index score by 0.99 (95% CI = 0.37, 1.61; I = 0.0%; fixed-effect model). Meanwhile, BW training was associated with an increase in open-eyes single leg standing duration by 0.91 s (95% CI = 0.29, 1.53; I = 75.9%; random-effect model) in comparison to control.
BW training could serve as a potentially useful tool to improve balance performance among those with a high risk of fall. However, current evidence remains preliminary due to the small cohort of studies and possible learning effect in pre-post studies. Future work with larger scale and randomized experimental design is warranted to evaluate the effectiveness of BW training on balance performance across diverse population and disease subgroups, and elucidate the underlying biomechanical and neurological pathways.
倒走（BW）训练被认为可通过改善运动系统本体感觉和步态特征来影响平衡能力，但相关证据仍然稀少且尚无定论。
本研究系统评价并量化了关于BW训练对平衡能力有效性的科学证据。
在六个电子数据库（PubMed、Web of science、SPORTDiscus、CINAHL、Cochrane图书馆和中国知网）中对BW训练干预措施进行关键词和参考文献检索，以查找截至2017年11月发表的经同行评审的文章。使用标准化表格从每篇符合预先设定纳入标准的选定文章中提取数据。进行荟萃分析以估计BW训练对平衡能力测量指标的综合效应。
11项研究（9项随机对照试验和2项前后对照研究）符合纳入标准并被纳入本综述。所有研究均报告了BW训练对平衡能力有一些有益影响。与对照组相比，BW训练使总体稳定性指数得分降低0.99（95%CI = 0.37, 1.61；I² = 0.0%；固定效应模型），内外侧稳定性指数得分降低0.95（95%CI = 0.34, 1.57；I² = 0.0%；固定效应模型），前后稳定性指数得分降低0.99（95%CI = 0.37, 1.61；I² = 0.0%；固定效应模型）。同时，与对照组相比，BW训练使睁眼单腿站立持续时间增加0.91秒（��5%CI = 0.29, 1.53；I² = 75.9%；随机效应模型）。
BW训练可作为改善跌倒高危人群平衡能力的潜在有用工具。然而，由于研究队列较小以及前后对照研究中可能存在的学习效应，目前的证据仍然初步。有必要开展未来工作，采用更大规模和随机实验设计，以评估BW训练对不同人群和疾病亚组平衡能力的有效性，并阐明潜在的生物力学和神经学途径。
