The Effect of Backward Walking Training in the Elderly

NCT05409534 | Completed

• 1 other identifier: AYSE TORAMAN KARAGULMEZ
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

Foot problems are among the most common reasons for elderly individuals to apply to health care centers. With aging, changes occur in the appearance, biomechanics, posture and function of the foot. These changes cause deterioration in balance, increase in the risk of falling, fracture formation, limitation in mobility and activities. In recent years, backward walking seems to have become a popular treatment in rehabilitation. The walking cycle, which we start with a heel strike in our normal forward walking, starts with finger contact while walking backwards. It has been stated that this situation affects the entire plantar pressure distribution and provides a more equal distribution of plantar pressure. Therefore, gait modifications seem to affect foot biomechanics. It is not yet known how backward walking training affects foot biomechanics, balance and kinesiophobia in elderly individuals. By improving the ability to walk backwards, it may be possible to improve foot functions, increase mobility function, improve balance ability, and reduce the fear of falling and the incidence of falling. In addition, this training is easy to learn and popular, and has the advantage of being low cost. The aim of this study is to evaluate the effects of backward walking training on ankle joint position sense, foot posture and functions, lower extremity muscle strength, balance, kinesiophobia status and fall incidence in elderly individuals staying in nursing homes.

Conditions

Elderly People

Keywords

balance; falls; elderly; foot

Outcome Measures

Primary Outcomes (10)

• Balance Performance

  Timed Get Up and Go: In the test, the person will be asked to get up from his chair, walk 3 meters at a safe and normal speed, turn, walk back and sit on the chair, accompanied by a stopwatch, and the time will be recorded in seconds. Three repetitions will be performed and the average of the three measurements will be recorded. Completion of the test in a short time means better balance performance.

  Pre test -Post test (At the end of 8 weeks treatment)

• Lower extremity muscle strength

  Sit-Up Chair Test: The number of times the individual sits and stands in a chair during 30 seconds will be recorded as the individual's score.

  Pre test -Post test (At the end of 8 weeks treatment)

• Kinesiophobia

  Tampa Kinesiophobia Scale:Responses on the Tampa Kinesiophobia Scale are classified as strongly disagree, disagree, agree and strongly agree. There are two types of expressions (direct and inverse) in the scale. While these expressions are scored, those who get 1 point turn into 4, and those who get 4 points turn into 1. 4-point answers in direct statements indicate a high level of kinesiophobia. In reversed expressions, answers with a value of 1 indicate a high level of kinesiophobia, and answers with a value of 4 indicate a low level of kinesiophobia. Scores from the scale range from 17 to 68. The score obtained from the scale constitutes the individual's score that should be interpreted at the level of kinesiophobia. A high score indicates a high level of kinesiophobia.

  Pre test -Post test (At the end of 8 weeks treatment)

• Fear of Falling

  The International Falling Efficiency Scale: The answers given in the international fall efficiency scale are classified as (1) I am not worried at all, (2) I am a little worried, (3) I am very worried, (4) I am very worried. The total score is scored between 16 (no fear of falling) to 64 (excessive fear of falling).The cut-off point is 24 points to distinguish between people with a fear of falling and those without a fear of falling.

  Pre test -Post test (At the end of 8 weeks treatment)

• Forward Walking Speed

  10 meters Forward Walk Test:The time it takes to cover the ten meters at the person's normal speed will be recorded. The test is done twice and the average value is recorded in seconds. Then, 10 meters is divided by this obtained value and recorded in meters/second.

  Pre test -Post test (At the end of 8 weeks treatment)

• Backward Walking Speed

  3 meters Backward Walk Test:The time taken for the person to walk backwards as fast as possible will be recorded. The test is done once and its duration is recorded in seconds with a stopwatch. Then, 3 meters is divided by this obtained value and recorded in meters/second.

  Pre test -Post test (At the end of 8 weeks treatment)

• Foot Posture

  Foot Posture İndex: The test score is calculated by assigning values between -2 and +2 to the 6 criteria on the foot and summing the scores from all criteria. A test score of 0 indicates that the foot is in a neutral position. A positive test score indicates standing pronation. A negative test score indicates standing supination.

  Pre test -Post test (At the end of 8 weeks treatment)

• Foot Function

  Foot Function İndex:The scale consists of three subscales: pain, disability, and activity limitation. There are 23 questions in total. The participants are asked to score all questions with a visual analog scale scaled between 0-10, taking into account their foot condition in the last week. To calculate the sub-scales and the total score, the score of each item is added, divided by the sum of the maximum scores of the items and multiplied by 100. Higher scores indicate more pain, disability, and activity limitation.

  Pre test -Post test (At the end of 8 weeks treatment)

• Ankle Joint Position Sense

  Individuals will be asked to bring their neutral feet to the desired target positions (10 degrees of dorsiflexion, 10 degrees of plantar flexion, 20 degrees of plantar flexion). Measurements will be repeated 3 times for each target angle. The absolute value of the deviations from the target angles will be recorded and the average of the deviations occurring during the 3 repetitions will be taken. A small amount of deviation from target angle means good Ankle Joint Position Sense.

  Pre test -Post test (At the end of 8 weeks treatment)

• Functional Exercise Capacity

  Six-minute walk test: The distance traveled will be measured by walking in a straight 30-meter corridor for six minutes. More distance traveled indicates better functional capacity.

  Pre test -Post test (At the end of 8 weeks treatment)

Secondary Outcomes (2)

• Cognitive status

  Pre test -Post test (At the end of 8 weeks treatment)

• Fall incidence

  for three months after two months of treatment

Study Arms (2)

Backward Walking

ACTIVE COMPARATOR

Participants who walk backward gait in the form of exercise program

Other: Backward Walking (Exercise group)

Forward Walking

ACTIVE COMPARATOR

Participants who walk forward gait in the form of home program

Other: Forward Walking (Control Group)

Interventions

Backward Walking (Exercise group) OTHER

The participant will apply a maximum of 40-50 minutes of exercise, including 10 minutes of warm-up exercise, 30 minutes of backward walking training and 10 minutes of cooling-off exercise. The maximum time to do backward walking training will be 30 minutes. In the backward walking exercise, 1 set will take 5 minutes. The maximum number of sets that can be made will be 6 sets. No more than 6 sets will be made.

Backward Walking

Forward Walking (Control Group) OTHER

The participant will apply a maximum of 40-50 minutes of exercise, including 10 minutes of warm-up exercise, 30 minutes of forward walking training and 10 minutes of cooling-off exercise as the home exercise programme.

Forward Walking

Eligibility Criteria

• Age: 65 Years - 95 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Being 65 years of age and older
• Stay in a nursing home
• Getting a score of 24 or higher on the Standardized Mini Mental State Test
• Being able to walk with a cane or without a cane
• Know how to read and write

You may not qualify if:

• Being vision problem that cannot be corrected with glasses or lenses
• Being hear problem that cannot be corrected with hearing aids
• Being blood pressure unsafe for exercise (\>180/100 or \<100/60 mmHg at rest)
• Being severe respiratory and cardiac problems (previous congestive heart failure, transient ischemic attacks)
• History of lower extremity surgery in the last six months
• Being severe orthopedic and neurological deficits that may affect walking
• History of recurrent falls (more than one fall in the last year)
• Being do exercise more than 150 minutes a week
• Participating in any exercise program in the last six months
• Three or not participating in more exercise sessions

Sponsors & Collaborators

• Ayşe Toraman: lead

Study Sites (1)

Zonguldak Center, Kdz. Ereğli İzmirlioğlu, Devrek and Çaycuma Nursing Homes

Zonguldak, Center, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Control Groups

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Officials

• Ayşe T KARAGÜLMEZ

  Ankara Yildirim Beyazıt University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: İn this context, individuals included in the study will be assigned to the control and intervention groups respectively, randomized by an expert statistician and received in closed envelopes
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Lecturer

Model Details: 26 for intervention 1 (Backward Walking Exercise) group and 26 for intervention 2 (Forward Walking Home Exercise) group

Study Record Dates

• First Submitted: May 28, 2022
• First Posted: June 8, 2022
• Study Start: February 24, 2023
• Primary Completion: January 2, 2024
• Study Completion: March 29, 2024
• Last Updated: August 9, 2024

Record last verified: 2024-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)