Academy of Neurologic Physical Therapy Podcast · Academy of Neurologic Physical Therapy

DD SIG Episode 56: Proprioceptive Reliance During Backward Walking in People with MS with Patrick Monaghan & Michael VanNostrand

June 25, 2025·41 min·2 clips

Backward walking showed proprioception mattered more than ambulation disability in the model.

The conversation starts with a paper on examination of proprioceptive reliance during backward walking in individuals with multiple sclerosis. The hosts bring on two Wayne State University postdoctoral fellows to discuss that work. The setup is direct. From there, the conversation moves through why backward walking was chosen, how it may challenge mobility differently from forward gait, and what that means for neurologic rehabilitation. Fall risk stays at the center. The guests explain that familiar measures such as the 25-foot walk can be useful, but they may not be sensitive enough to catch the kind of mobility change clinicians want to spot early. Measurement gets close scrutiny. The discussion returns to gait speed, timed walking, and the practical question of whether a harder task could help the field predict problems before a fall happens. The scope widens next. A scoping review across stroke, Parkinson's disease, multiple sclerosis, spinal cord injury, and progressive supranuclear palsy suggests that backward walking has value both as an assessment and as an intervention. That pattern matters. Across those neurological conditions, the guests point to repeated signs that backward or multidirectional walking can improve mobility performance more than traditional forward-walking approaches. The tone stays clinical. Rather than selling a trend, the conversation keeps returning to what therapists can actually use in clinic, including the idea that a harder task may surface deficits earlier and more clearly. MS remains the anchor. Even when the discussion broadens to other neurologic diagnoses, it keeps coming back to people with MS and the question of how proprioceptive reliance affects real-world walking. The hosts stay practical. They ask about the way the study fits into day-to-day assessment decisions, the language clinicians use for walking performance, and why translating everything into one familiar metric may hide useful nuance. The ending is easy. The closing banter is collegial and light, but the episode's deeper message is steady: backward walking deserves attention as a potentially sharper lens on mobility, balance, and fall risk in neurologic rehab.

As heard by us

Backward walking sharpens the discussion of balance, mobility, and fall risk in MS.

Backwards walking gives this episode a clear practical edge. The episode keeps returning to one question: what can a harder gait task reveal in multiple sclerosis that the familiar 25-foot walk may miss?

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Why you'd press play

If you want a sharper read on why backward walking matters in MS.

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