The effect of virtual reality-based balance training on motor learning and postural control in healthy adults: a randomized preliminary study

Thunyanoot Prasertsakul, Panya Kaimuk, Wipawee Chinjenpradit, Weerawat Limroongreungrat, Warakorn Charoensuk, Thunyanoot Prasertsakul, Panya Kaimuk, Wipawee Chinjenpradit, Weerawat Limroongreungrat, Warakorn Charoensuk

Abstract

Background: Adults with sedentary lifestyles seem to face a higher risk of falling in their later years. Several causes, such as impairment of strength, coordination, and cognitive function, influence worsening health conditions, including balancing ability. Many modalities can be applied to improve the balance function and prevent falling. Several studies have also recorded the effects of balance training in elderly adults for fall prevention. Accordingly, the aim of this study is to define the effect of virtual reality-based balance training on motor learning and postural control abilities in healthy adults.

Methods: For this study, ten subjects were randomly allocated into either the conventional exercise (CON) or the virtual reality (VR) group. The CON group underwent physical balance training, while the VR group used the virtual reality system 4 weeks. In the VR group, the scores from three game modes were utilized to describe the effect of motor learning and define the learning curves that were derived with the power law function. Wilcoxon Signed Ranks Test was performed to analyze the postural control in five standing tasks, and data were collected with the help of a force plate.

Results: The average score was used to describe the effect of motor learning by deriving the mathematical models for determining the learning curve. Additionally, the models were classified into two exponential functions that relied on the aim and requirement skills. A negative exponential function was observed in the game mode, which requires the cognitive-motor function. In contrast, a positive exponential function was found in the game with use of only the motor skill. Moreover, this curve and its model were also used to describe the effect of learning in the long term and the ratio of difficulty in each game. In the balance performance, there was a significant decrease in the center of pressure parameters in the VR group, while in the CON group, there was a significant increase in the parameters during some foot placements, especially in the medio-lateral direction.

Conclusion: The proposed VR-based training relies on the effect of motor learning in long-term training though different kinds of task training. In postural analysis, both exercise programs are emphasized to improve the balance ability in healthy adults. However, the virtual reality system can promote better outcomes to improve postural control post exercising. Trial registration Retrospectively registered on 25 April 2018. Trial number TCTR20180430005.

Keywords: Balance performance; Balance training; Motor learning; Physical balance exercise; Virtual reality.

Figures

Fig. 1
Fig. 1
The process of interaction in the virtual environment by the Kinect sensor
Fig. 2
Fig. 2
The process of collecting the score for the dual-task virtual reality balance training (DTVRBT) system
Fig. 3
Fig. 3
Interface of three game modes consisting of A matching color, B bakery, and C memo number
Fig. 4
Fig. 4
The average scores from three games, i.e., matching color, bakery, and memo number, in twelve training sessions for four participants
Fig. 5
Fig. 5
The average score and fitted curves from three equations of the three game modes

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