The Immediate Effect of Backward Walking Exercise on the Posture and Postural Control of a Patient with Parkinson’s Disease

Abstract

[Purpose] The stooped posture, which limits various motions and increases the risk of falling, is one of the symptoms accompanying Parkinson’s Disease (PD). It was recently reported that backward walking exercise improved the posture and the ability of forward walking of PD patients. However, the detailed mechanisms of these effects still remain unclear. The purpose of this study was to clarify the mechanisms of the immediate effects of backward walking exercise on the posture and postural control of a patient with PD. [Subject] The backward walking exercise and evaluation of the changes in terms of the posture and postural control abilities were conducted for a PD patient (Hoehn & Yahr Stage III) with moderate stooped posture. [Methods] We evaluated the change of the posture, the center of gravity (COG), and the center of pressure (COP) using a force plate and a three-dimensional motion analysis system in 3 kinds of tasks performed by the patient: the static standing posture, the functional reach test (FR) and the cross test (CT). The measurements were performed just before and after a 5-minute backward walking exercise. [Results] In the static standing posture, both COG and COP moved backward and the stooped posture seemed to be moderately improved just after the backward walking exercise. Also, the extent of ankle strategy in postural control in the FR task increased in comparison with the hip strategy, and both COG and COP moved more forward in the CT task after the backward walking exercise. [Conclusion] The results suggest that the backward walking exercise moderately improved the stooped posture and postural control through greater dependence on ankle strategy than on hip strategy, and these effects lead to increased stability in both standing and walking of the patient with PD.