Additional acute effects of virtual reality head-mounted displays on balance outcomes in non-disabled individuals: a proof-of-concept study

Eduardo De Moura Neto,Luciane Aparecida Pascucci Sande De Souza,Gustavo José Luvizutto,Dayane Aparecida Viana,Danilo Santos Rocha,Douglas Reis Abdalla,Bruno Henrique De Souza Fonseca

doi:10.1590/s1980-657420220006721

Eduardo De Moura Neto, Luciane Aparecida Pascucci Sande De Souza + Show 5 more

Open Access

https://doi.org/10.1590/s1980-657420220006721

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Abstract

Aim: This study aims to evaluate the additional acute effect of virtual reality (VR) head-mounted displays (HMD) when associated with balance exercises in balance outcomes in non-disabled individuals. Methods: Thirty individuals were randomized into two groups: balance exercise group (GBE; n = 15); and virtual reality + balance exercise group (GVR + BE; n = 15). The individuals were evaluated by static and dynamic balance using the tandem test (TT), single-leg stance (SLS), and Fukuda stepping test (FST). Both groups performed 30 min of balance exercises. The GVR + BE performed 8 additional minutes of virtual reality prior to balance exercises. A roller coaster application was used for the HMD. The Mann-Whitney test was used for intra-group and differences of inter-group analysis, considering a significance level of p < 0.05. Results: In the GBE group analysis, there was observed an increase of time in TT with closed eyes (p = 0.025) and SLS with closed eyes (p = 0.003). In the same way, the GVR + BE group increase TT with closed eyes (p = 0.003) and SLS with closed eyes (p = 0.002) after the intervention. In the intergroup analysis, the increase in the SLS with closed eyes was superior in the GVR + BE group when compared with GBE (p = 0.006; d = 1.67). Conclusion: The use of HMD in combination with balance exercise has an acute effect on increasing static balance in non-disabled individuals.

Highlights

Postural control involves the coordination of sensorymotor strategies to stabilize the body mass center during postural instability[1,2] and can be altered by somatosensory demands[3,4]
The individuals were randomly assigned to the Center of Rehabilitation of Faculty of Human Talent and subjected to static and dynamic balance evaluation conditioned in three treatment groups: 1) GBE: treatment with conventional balance exercises (15 individuals); GVR + BE: treatment with head-mounted displays (HMD) and conventional balance exercises (15 individuals)
The increase in the single-leg stance (SLS) with closed eyes was superior in the GVR + BE group when compared with GBE (p = 0.006; d = 1,67)

Summary

Introduction

Postural control involves the coordination of sensorymotor strategies to stabilize the body mass center during postural instability[1,2] and can be altered by somatosensory demands[3,4]. The influence of sensory input or integration of multisensory inputs of postural control was widely investigated[5,6,7,8]. Multisensory reweighting of visual, vestibular, and somatosensory inputs allows us to maintain balance as environmental conditions change[6]. Allison et al.[7] reported that sensory reweighting exercises by manipulating surface and visual conditions would benefit postural stability in adults[8]. One of the ways of reweighting multisensory inputs in non-disabled individuals is through the use of immersive virtual reality (VR) by somatosensory and visual conflict. VR with two-dimensional presentations is considered non-immersive. Three-dimensional presentations utilizing stereoscopic projections or displays with a fixed visual perspective are considered semiimmersive. Immersive systems allow for changing visual perspective with head movement[9,10,11]

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