• Ting Liu, Kailiang Luo, Kun Zhou, Zekai Hu, Yating Ji, Wuyi Feng, Shujie Ma, and Jun Hu.
• School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
• Brit J Hosp Med. 2024 Aug 30; 85 (8): 1111-11.

AbstractAims/Background Backward walking is gaining traction in rehabilitation therapy, showing promise as an intervention for stroke patients with walking difficulties. However, the brain activity patterns (neurophysiological mechanisms) underlying backward walking in these patients remain unclear. This study investigated the neurophysiological mechanism in stroke patients within 1 year of their stroke. Methods Twenty-four subjects walked forward and backward for 5 min on an 8-m track while their electroencephalographic signals were collected. The power values of each frequency band were compared during forward and backward walking, and the delta to alpha power ratio (DAR) was calculated. Results The results showed a significant increase in α-band activity within the frontal cortex during backward walking (p < 0.05). This increase correlated positively with scores on the Fugl-Meyer lower extremity motor function assessment scale. Similarly, α-band activity showed significant enhancement within the right parietal cortex during backward walking (p < 0.05). There were no significant differences between forward and backward walking states in δ, θ, and β wavebands across the entire brain region (p > 0.05). Additionally, the DAR was significantly lower during backward walking than during forward walking (p < 0.05). Conclusion This study suggests that backward walking may more effectively activate neural activity in the prefrontal and right posterior parietal cortices. This finding supports the potential of backward walking to enhance motor execution and walking function in stroke patients, thereby supporting its application as a rehabilitation method.

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