Somatosensory and Vestibular Enhancement of Adaptation in Falls - SaVE -A-Fall

The aim of this study was to investigate the possible improvement of postural stability when healthy younger and older adults were repeatedly exposed to an immersive virtual environment.

Twenty subjects were included in the younger group (mean age 24.5) and twenty-seven in the older group (mean age 71.3). Both groups were exposed to VR stimuli, standing on a force plate, assessing postural sway. The younger group watched a roller coaster ride and the older group a 360° “walking in a grocery store” video, including numerous stops/starts and quick turns. The movies were repeated five times with rests between.

In the younger group, repeatedly watching the same VR movie significantly reduced both the anteroposterior (62%, p 0.001) and lateral (47%, p = 0.001) energy used. However, females adapted more slowly to the VR stimuli as reflected by higher use of total (p = 0.007), low frequency (p = 0.027) and high frequency (p = 0.026) energy.

In the older group, the first VR session produced a marked stability challenge, reflected by significantly increased use of anteroposterior and lateral total (p0.001) and high frequency (p0.001) energy compared with the control test quiet stance eyes open. However, repeated VR sessions produced a multidimensional decrease in used total (p0.001), low (p=0.002), and high frequency energy (p0.001). Participants used more energy in anteroposterior compare with lateral direction across VR sessions within all spectral ranges (p0.001). Participants with higher physical activity level used less low frequency energy in anteroposterior direction during VR session 1 (p=0.033).

Both groups adapted to the distortive visual environments, shown as reduced postural sway during the consecutive tasks. Thus, CNS can utilize the information provided by a few repeated VR sessions into suitable movement strategies that have a simultaneous multidimensionally positive effect. 

Virtual Reality may introduce opportunities to customize or develop novel rehabilitation approaches to address persistent balance impairments.

Publications:

1. Fransson P-A, Patel M, Jensen H, Lundberg M, Tjernström F, Magnusson M, Ekvall Hansson E. Postural instability in an immersive Virtual Reality adapts with repetition and includes directional and gender specific effects. Scientific Reports: 2019 :9: 3168  
2. Älmqvist Nae J, Nyström A, Luccini F, Magnusson M, Ekvall Hansson E. Video exposure through virtual reality can improve older people's ability to manage postural instability caused by distortive visual environments. PLoS One. 2024 Aug 21;19(8):e0306834. doi: 10.1371/journal.pone.0306834. PMID: 39167614;