What is the most effective type of audio-biofeedback for postural motor learning?

Abstract

Biofeedback is known to improve postural control and reduce postural sway. However, the effects that different biofeedback modes (coding for more or less complex movement information) may have on postural control improvement are still poorly investigated. In addition, most studies do not take into account the effects of spontaneous motor learning from repetition of a task when investigating biofeedback-induced improvement in postural control. In this study, we compared the effects of four different modes of audio-biofeedback (ABF), including direction and/or magnitude of sway information or just a non-specific-direction alarm, on the postural sway of 13 young healthy adults standing on a continuously rotating surface. Compared to the non-specific-direction alarm, ABF of continuous postural sway direction and/or amplitude resulted in larger postural sway reduction in the beginning of the experiment. However, over time, spontaneous postural motor learning flattened the effects of the different modes of ABF so that the alarm was as effective as more complex information about body sway. Nevertheless, motor learning did not make ABF useless, since all modes of ABF further reduced postural sway, even after subjects learned the task. All modes of ABF resulted in improved multi-segmental control of posture and stabilized the trunk-in-space. Spontaneous motor learning also improved multi-segmental control of posture but not trunk-in-space stabilization as much as ABF. In conclusion, although practice standing on a perturbing surface improved postural stability, the more body sway information provided to subjects using ABF, the greater the additional improvement in postural stability.