Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review.

OBJECTIVE: Backward walking (BW) has gained increasing attention as a clinically relevant assessment and intervention for individuals with neurological conditions. Given the heterogeneity in how BW has been applied and studied across neurological populations, the objectives of this scoping review were to synthesize the literature related to: 1) the reliability and validity of BW mobility assessments, 2) the utility of BW as a clinical assessment tool, and 3) the efficacy of BW as an exercise intervention. DATA SOURCES: A literature search of six electronic databases and citation searching were conducted through June 9th, 2025. Articles were included in this review if they were peer-reviewed studies involving adults with a central nervous system neurological disorder and met at least one of the following criteria: assessed the reliability or validity of BW, used BW as a clinical assessment tool, or implemented BW as part of an exercise intervention. RESULTS: Fifty-nine studies were included, examining BW's reliability/validity (n = 14), use as a clinical assessment (n = 17), and role in interventions (n = 28). BW showed high reliability and moderate-to-strong correlations with established measures, outperformed other assessments in discriminating fall risk and mobility status, and improved gait speed, balance, and postural control when used in interventions. CONCLUSION: BW is a reliable, valid marker of mobility and balance that better distinguishes fall risk and mobility status than common assessments and shows promise as an intervention to improve gait, balance, and postural control. However, methodological inconsistencies and limited longitudinal data warrant further research to standardize assessment protocols and optimize intervention strategies.