Effect of retro walking training on physical performance and fear of falling among elderly population- A quasi experimental study.

Falls are a major health concem in older adults due to its post fall-related injury and disability. In a worldwide meta-analysis of over 36 million individuals, about 26.5% of older people reported a fall in a given period. In developed countries, roughly one in four adults over age 65 falls each year, making falls the leading cause of fatal and non-fatal injuries in this group. Importantly, many fallers develop a lasting fear of falling, which can trigger activity avoidance and functional decline. Studies report that about half of older adults report significant concern about falling during daily activities. Backward walking ("retro gait") has emerged as a novel exercise with a strong physiological rationale for improving balance and mobility. It engages the lower limbs and postural control systems in unique ways: for example, it recruits quadriceps and hip muscles differently and requires continuous conscious balance adjustments. Backward gait training is thought to enhance sensorimotor integration and proprioception more than ordinary forward walking. Backward walking adults exhibit shorter stride length, altered intersegmental coordination, and broader patterns of muscle activation suggesting age-related adjustments in spinal motor output. In community-dwelling seniors, a randomized trial by Maritz et al. found that ten sessions of backward walking training significantly improved dynamic balance (Mini-BESTest) and functional mobility (Timed Up and Go) compared to a no-exercise control. In summary, Emerging high-quality evidence supports the benefits of backward walking training for balance and mobility in older at the risk of populations

Despite the theoretical benefits of backward walking, rigorous trials in middle-aged elders are lacking. A recent systematic review found only nine RCTs of backward walking training (with mixed populations) and stressed that evidence is "sparse and inconclusive". Most of the studies have involved frail or very old cohorts. There is a notable gap for healthy individuals in the 55—65 age range. Moreover, even when exercise trials assess balance and strength, they rarely measure fear of falling. While general exercise programs (e.g. multi-component balance training) have been shown to reduce fear of falling in older adults no RCT has specifically examined whether backward-walking exercise can improve falls self-efficacy.  Thus, targeted research is needed to detennine if backward gait training can enhance functional mobility and lessen fear of falling in 55—65-year-olds.