This study demonstrates that backward walking
plus conventional training is an effective and safe
approach. It can result in superior walking ability
in ambulatory hemiparetic patients comparing
with running mere conventional rehabilitation
programmes without backward walking. Thomas
and Fast presented two cases in which walking
backwards during physical therapy resulted in a
fall and considerable morbidity.45 They therefore
doubted the safety of walking backwards. In this
study, none of our subjects fell down during
backward walking training. Backward walking
requires a greater reliance on neuromuscular control,
proprioception and protective reflexes because
of the elimination of visual cues. It is important
that adequate safeguards should be provided when
backward walking is prescribed.