Effects of Dual-Task Training With and Without Backward Walking on Balance, Functional Mobility, and Participation in Ambulatory Children With Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial.
Aqsa Butt, Maira Pervez, Adeena Nisar et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled trial compared dual-task training (DTT) with DTT incorporating backward walking (BW) in 44 ambulatory children aged 6–12 years with spastic diplegic cerebral palsy (GMFCS I–II). Both groups trained four times weekly for four weeks. TUG times improved in both groups, with a significant group-by-time interaction favoring DTT + BW (p = 0.003; partial η² = 0.190), corresponding to an approximately 1 s additional improvement. No significant between-group interaction was found for balance or participation. The clinical importance of the mobility difference is uncertain.
Key findings
- TUG times fell from 20.82 ± 4.04 to 17.23 ± 4.05 s with DTT and from 21.41 ± 3.22 to 16.86 ± 3.24 s with DTT + BW; the interaction was significant (p = 0.003).
- Balance improved in both groups, but the group-by-time interaction was not significant (p = 0.680).
- Participation scores increased in both groups; superiority of DTT + BW was not demonstrated (interaction p = 0.052).
Why it matters
The findings suggest that incorporating backward walking into a time-matched dual-task programme may yield a modest additional short-term improvement in functional mobility for ambulatory children with spastic diplegic cerebral palsy. The absence of demonstrated superiority for balance or participation, and uncertainty about the clinical importance of the mobility difference, help frame the result as a targeted rather than broad benefit.
What to keep in mind
Outcomes were assessed only immediately after four weeks, and the trial was not powered for secondary outcomes. Without a non-DTT comparison group, it cannot establish the standalone efficacy of DTT.