Backward walking measures are sensitive to age-related changes in mobility and balance

Many falls occur from backward perturbations or during transitional movements that require a person to turn and step backwards, suggesting that deficits in backward stepping may negatively impact mobility. Previous studies found significant declines in backward walking (BW) spatiotemporal measures in healthy elderly compared to young adults. No studies to date have examined BW performance in middle-aged adults and in elderly with impaired mobility. This study compared spatiotemporal measures of BW and forward walking (FW) in young, middle-aged, and elderly and in elderly fallers and non-fallers; and compared the strength of the relationship between age and BW and FW spatiotemporal measures to determine the utility of BW performance as a clinical tool for examining safety and mobility. BW measures were significantly more impaired in the elderly (n = 62) compared to young (n = 37) and middle-aged (n = 31) adults and age effects were greater in BW than FW. No significant differences were found between young and middle-aged except for base of support in BW. Stronger correlations were found between age and BW measures than between age and FW measures, particularly correlations between age and BW velocity and stride length. Elderly fallers had greater deficits in BW performance than non-fallers. All elderly fallers had BW velocities <.6 m/s. Clinicians are encouraged to assess BW, particularly BW velocity, as part of mobility examinations.

► Gait measures in backward and forward walking were equal in young and middle-aged. ► Backward walking declined significantly in the elderly group. ► Backward walk velocity and stride length were closely associated with age. ► All elderly fallers walked backward at a speed less than .6 m/s. ► Backward walking should be assessed as part of the standard mobility evaluation.