University of Florida, Gainesville, Florida, USA.
Brooks Rehabilitation, Jacksonville, Florida, USA.
Phys Ther. 2021 May 4;101(5). doi: 10.1093/ptj/pzab050.
Forward walking speed (FWS) is known to be an important predictor of mobility, falls, and falls-related efficacy poststroke. However, backward walking speed (BWS) is emerging as an assessment tool to reveal mobility deficits in people poststroke that may not be apparent with FWS alone. Since backward walking is more challenging than forward walking, falls efficacy may play a role in the relationship between one's preferred FWS and BWS. We tested the hypothesis that people with lower falls efficacy would have a stronger positive relationship between FWS and BWS than those with higher falls efficacy.
Forty-five individuals (12.9 ± 5.6 months poststroke) participated in this observational study. We assessed FWS with the 10-meter walk test and BWS with the 3-meter backward walk test. The modified Falls-Efficacy Scale (mFES) quantified falls efficacy. A moderated regression analysis examined the hypothesis.
FWS was positively associated with BWS (R2 = 0.26). The addition of the interaction term FWS × mFES explained 7.6% additional variance in BWS. As hypothesized, analysis of the interaction revealed that people with lower falls efficacy (mFES ≤ 6.6) had a significantly positive relationship between their preferred FWS and BWS, whereas people with higher falls efficacy (mFES > 6.6) had no relationship between their walking speed in the 2 directions.
FWS is positively related to BWS poststroke, but this relationship is influenced by one's perceived falls efficacy. Our results suggest that BWS can be predicted from FWS in people with lower falls efficacy, but as falls efficacy increases, BWS becomes a separate and unassociated construct from FWS.
This study provides unique evidence that the degree of falls efficacy significantly influences the relationship between FWS and BWS poststroke. Physical therapists should examine both FWS and BWS in people with higher falls efficacy, but further investigation is warranted for those with lower falls efficacy.
向前行走速度（FWS）已知是移动性、跌倒和卒中后跌倒相关效果的重要预测指标。然而，向后行走速度（BWS）作为一种评估工具正在出现，以揭示单独使用 FWS 可能不明显的卒中后患者的移动能力缺陷。由于向后行走比向前行走更具挑战性，因此跌倒效果可能在一个人的首选 FWS 和 BWS 之间的关系中起作用。我们检验了以下假设：跌倒效果较低的人 FWS 和 BWS 之间的正相关关系比跌倒效果较高的人更强。
45 名个体（卒中后 12.9±5.6 个月）参加了这项观察性研究。我们使用 10 米步行测试评估 FWS，使用 3 米向后步行测试评估 BWS。改良跌倒效果量表（mFES）量化了跌倒效果。使用调节回归分析检验了假设。
FWS 与 BWS 呈正相关（R2=0.26）。加入 FWS×mFES 交互项解释了 BWS 7.6%的额外方差。正如假设的那样，对交互作用的分析表明，跌倒效果较低的人（mFES≤6.6）在其首选 FWS 和 BWS 之间存在显著的正相关关系，而跌倒效果较高的人（mFES＞6.6）在这两个方向的行走速度之间没有关系。
卒中后 FWS 与 BWS 呈正相关，但这种关系受到个体感知跌倒效果的影响。我们的研究结果表明，在跌倒效果较低的人中，可以从 FWS 预测 BWS，但随着跌倒效果的增加，BWS 成为与 FWS 无关的独立构念。
这项研究提供了独特的证据，表明跌倒效果的程度显著影响卒中后 FWS 和 BWS 之间的关系。物理治疗师应该在跌倒效果较高的人群中同时检查 FWS 和 BWS，但对于跌倒效果较低的人群，需要进一步调查。
