Virtual-Reality-Induced Visual Perturbations Impact Postural Control System Behavior

Harish Chander, Sachini N K Kodithuwakku Arachchige, Christopher M Hill, Alana J Turner, Shuchisnigdha Deb, Alireza Shojaei, Christopher Hudson, Adam C Knight, Daniel W Carruth, Harish Chander, Sachini N K Kodithuwakku Arachchige, Christopher M Hill, Alana J Turner, Shuchisnigdha Deb, Alireza Shojaei, Christopher Hudson, Adam C Knight, Daniel W Carruth

Abstract

Background: Virtual reality (VR) is becoming a widespread tool in rehabilitation, especially for postural stability. However, the impact of using VR in a "moving wall paradigm" (visual perturbation), specifically without and with anticipation of the perturbation, is unknown.

Methods: Nineteen healthy subjects performed three trials of static balance testing on a force plate under three different conditions: baseline (no perturbation), unexpected VR perturbation, and expected VR perturbation. The statistical analysis consisted of a 1 × 3 repeated-measures ANOVA to test for differences in the center of pressure (COP) displacement, 95% ellipsoid area, and COP sway velocity.

Results: The expected perturbation rendered significantly lower (p < 0.05) COP displacements and 95% ellipsoid area compared to the unexpected condition. A significantly higher (p < 0.05) sway velocity was also observed in the expected condition compared to the unexpected condition.

Conclusions: Postural stability was lowered during unexpected visual perturbations compared to both during baseline and during expected visual perturbations, suggesting that conflicting visual feedback induced postural instability due to compensatory postural responses. However, during expected visual perturbations, significantly lowered postural sway displacement and area were achieved by increasing the sway velocity, suggesting the occurrence of postural behavior due to anticipatory postural responses. Finally, the study also concluded that VR could be used to induce different postural responses by providing visual perturbations to the postural control system, which can subsequently be used as an effective and low-cost tool for postural stability training and rehabilitation.

Keywords: postural control; postural stability behavior; virtual reality; visual perturbations.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of the experimental procedures followed for each participant.
Figure 2
Figure 2
Virtual environments used in the study. Left: lobby environment, right: closed room environment.
Figure 3
Figure 3
Participant being tested for postural stability wearing a virtual reality (VR) headset.
Figure 4
Figure 4
Center of pressure (COP) medial–lateral excursions (cm) during baseline, unexpected (UnExp) moving wall, and expected (Exp) moving wall conditions. Bars represent standard errors.
Figure 5
Figure 5
Center of pressure anterior–posterior excursions (cm) during baseline, unexpected (UnExp) moving wall, and expected (Exp) moving wall conditions. Bars represent standard errors. * Represents a significant difference at p < 0.05 compared to the baseline condition.
Figure 6
Figure 6
Center of pressure of the 95% ellipsoid sway area (cm2) during baseline, unexpected (UnExp) moving wall, and expected (Exp) moving wall conditions. Bars represent standard errors. * Represents a significant difference at p < 0.05 compared to the baseline condition.
Figure 7
Figure 7
Center of pressure average sway velocity (cm/s) during baseline, unexpected (UnExp) moving wall, and expected (Exp) moving wall conditions. Bars represent standard errors. * Represents a significant difference at p < 0.05 compared to the baseline condition.

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