Abstract
To provide a safe, simple, relatively inexpensive, fast, accurate way of quantifying balance performance either in isolation, or in the face of challenges provided by 3D high definition moving visual stimuli as well as by the proprioceptive challenge from standing on a foam pad. This method uses the new technology of the Wii balance board to measure postural stability during powerful, realistic visual challenges from immersive virtual reality. Present computerized methods for measuring postural stability are large, complex, slow, and expensive, and do not allow for testing the response to realistic visual challenges. Subjects stand on a 6 cm thick, firm, foam pad on a Wii balance board. They wear a fast, high resolution, low persistence, virtual reality head set (Oculus Rift DK2). This allows displays of varying speed, direction, depth, and complexity to be delivered. The subject experiences a visual illusion of real objects fixed relative to the world, and any of these displays can be perturbed in an unpredictable fashion. A special app (BalanceRite) used the same procedures for analyzing postural analysis as used by the Equitest. Four simple "proof of concept" experiments demonstrate that this technique matches the gold standard Equitest in terms of the measurement of postural stability but goes beyond the Equitest by measuring stability in the face of visual challenges, which are so powerful that even healthy subjects fall. The response to these challenges presents an opportunity for predicting falls and for rehabilitation of seniors and patients with poor postural stability. This new method provides a simpler, quicker, cheaper method of measurement than the Equitest. It may provide a new mode of training to prevent falls, by maintaining postural stability in the face of visual and proprioceptive challenges similar to those encountered in life.
Highlights
Falls are a major problem for seniors, with significant morbidity and mortality
Our aims were twofold: [1] to understand the weighting of proprioceptive and vestibular inputs in maintaining balance by using the Wii balance board (WBB) and WBB + f in eyes closed condition – eliminating visual input; [2] to provide a new method using virtual reality (VR) to answer the question: is maintaining balance an automatic process, or is maintaining balance a challenging task requiring attentional demands? We suggested that some people may lose their ability to maintain automatic balance, when they have eyes closed or are confronted by visual distractors
Results of the analysis are here shown for the XY velocities, but the correlations between Equitest platform and WBB measures were significant for both the X and the Y velocities as well
Summary
Falls are a major problem for seniors, with significant morbidity and mortality. Major physical injuries are relatively uncommon but are often associated with ongoing disability. Psychological sequelae such as fear of falling occur frequently and may lead to increased dependency. There are physical, psychosocial, and financial costs to the injured person. The cause of falls is usually multifactorial involving combination of age-related sensory, neural and muscular decline, chronic disease, medication, and environmental hazards. A multidisciplinary approach is often indicated for assessment and treatment of people who repeatedly fall
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