Haptic-Based Perception-Empathy Biofeedback Enhances Postural Motor Learning During High-Cognitive Load Task in Healthy Older Adults.

Kazuhiro Yasuda,Hiroyasu Iwata,Kenta Saichi

doi:10.3389/fmed.2018.00149

Abstract

Falls and fall-induced injuries are major global public health problems, and sensory input impairment in older adults results in significant limitations in feedback-type postural control. A haptic-based biofeedback (BF) system can be used for augmenting somatosensory input in older adults, and the application of this BF system can increase the objectivity of the feedback and encourage comparison with that provided by a trainer. Nevertheless, an optimal BF system that focuses on interpersonal feedback for balance training in older adults has not been proposed. Thus, we proposed a haptic-based perception-empathy BF system that provides information regarding the older adult's center-of-foot pressure pattern to the trainee and trainer for refining the motor learning effect. The first objective of this study was to examine the effect of this balance training regimen in healthy older adults performing a postural learning task. Second, this study aimed to determine whether BF training required high cognitive load to clarify its practicability in real-life settings. Twenty older adults were assigned to two groups: BF and control groups. Participants in both groups tried balance training in the single-leg stance while performing a cognitive task (i.e., serial subtraction task). Retention was tested 24 h later. Testing comprised balance performance measures (i.e., 95% confidence ellipse area and mean velocity of sway) and dual-task performance (number of responses and correct answers). Measurements of postural control using a force plate revealed that the stability of the single-leg stance was significantly lower in the BF group than in the control group during the balance task. The BF group retained the improvement in the 95% confidence ellipse area 24 h after the retention test. Results of dual-task performance during the balance task were not different between the two groups. These results confirmed the potential benefit of the proposed balance training regimen in designing successful motor learning programs for preventing falls in older adults.

Highlights

A previous study reported that 30–60% of healthy older adults experience falls annually and that 10–20% of such falls can result in injury, hospitalization, or death [1]
No significant difference was found between the BF and control groups in the number of answer (t = 0.60, p = 0.5567) and percentage of correct answer (t = 1.32, p = 0.2004; Figure 5). This initial study has shown that using the proposed system, the BF group was more effective in adapting to the postural control tasks than the control group, and the older participants retained these improvements over 24 h only for spatial variability, but not for the mean velocity of sway
Cognitive loads applied to the participants were not significantly different between the BF and control groups, suggesting that the cognitive burden of using the BF system is low

Summary

Introduction

A previous study reported that 30–60% of healthy older adults experience falls annually and that 10–20% of such falls can result in injury, hospitalization, or death [1]. Recurrent falls and impaired balance are among the most important risk factors for falls and should, be addressed in fall prevention programs. Risk factors for postural instability in older adults vary and encompass various diseases, including abnormalities in balance and gait [4]. The interplay between postural and voluntary movements on the basis of sensory control is significant in the performance of motor tasks [6]. In this context, sensory input impairment in older adults must result in significant limitations in feedback-type motor control [7]. Deficits in lower extremity joint proprioception or foot plantar sensory were found to be highly correlated with postural stability [8]

Objectives

Methods

Conclusion