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Randomized Controlled Trial
. 2018 May;62:342-348.
doi: 10.1016/j.gaitpost.2018.03.044. Epub 2018 Mar 28.

Trunk Motion Visual Feedback During Walking Improves Dynamic Balance in Older Adults: Assessor Blinded Randomized Controlled Trial

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Randomized Controlled Trial

Trunk Motion Visual Feedback During Walking Improves Dynamic Balance in Older Adults: Assessor Blinded Randomized Controlled Trial

Eric Anson et al. Gait Posture. .
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Background: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.

Research question: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.

Methods: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk.

Results: There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest.

Significance: Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.

Keywords: Balance; Exercise therapy; Gait; Visual biofeedback.

Conflict of interest statement

Disclosure of Interest

J Jeka, and E Anson disclose that they are listed as inventors of the sensory treadmill described in this experiment United States Patent# 8,900,165. All other authors have no conflict of interest.


Figure 1
Figure 1
CONSORT flow chart diagram.
Figure 2
Figure 2
Illustration of the experimental set-up. Participants walked on a treadmill in front of a TV with a bulls-eye display. Participants wore a safety harness (not depicted) that did not provide support unless they fell. A moving cursor representing either their center of mass translation or trunk orientation motion was superimposed over the bullseye target only for the experimental group.

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