Virtual reality obstacle avoidance training can be enhanced by physical feedback via perturbations: A proof-of-concept study

Yoshiro Okubo; Yixuan He; Matthew A Brodie; Cameron Hicks; Kim van Schooten; Nigel H Lovell; Kaarin J Anstey; Stephen R Lord; Juno Kim

doi:10.1016/j.apergo.2024.104442

Virtual reality obstacle avoidance training can be enhanced by physical feedback via perturbations: A proof-of-concept study

Appl Ergon. 2025 May:125:104442. doi: 10.1016/j.apergo.2024.104442. Epub 2024 Dec 16.

Authors

Yoshiro Okubo¹, Yixuan He², Matthew A Brodie³, Cameron Hicks², Kim van Schooten⁴, Nigel H Lovell⁵, Kaarin J Anstey⁶, Stephen R Lord⁴, Juno Kim⁷

Affiliations

¹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia; Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia. Electronic address: y.okubo@neura.edu.au.
² Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia.
³ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia.
⁴ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Sydney, NSW, Australia; Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia.
⁵ Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia; Tyree Institute of Health Engineering (IHealthE), University of New South Wales, Sydney, NSW, Australia.
⁶ Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia; Brain Health and Dementia Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Psychology, University of New South Wales, Sydney, NSW, Australia.
⁷ Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.

PMID: 39689670
DOI: 10.1016/j.apergo.2024.104442

Abstract

Background: Fall injuries resulting from trips are a major health concern. Virtual reality (VR) offers an effective way of training obstacle avoidance while walking due to its ability to provide safe and meaningful real-time feedback during rehabilitation. This proof-of-concept study examined the benefit of providing physical feedback during obstacle avoidance gait training using VR.

Methods: Twenty-six young adults walked on an instrumented treadmill while wearing a head-mounted display in two 8-min conditions. Virtual obstacles to be avoided were presented in a VR-only condition and a VR + Perturbation (VR + P) condition where additional rapid belt acceleration simulated tripping on an obstacle.

Results: A lower obstacle collision rate, greater step length and height of the leading foot over the obstacles were found in the VR + P condition compared to the VR-only condition (p < 0.05). Step height of the trailing foot over the obstacles significantly decreased over time during the VR-only condition (p < 0.01) but not during the VR + P condition. The margin of stability significantly improved over time during the VR + P condition only (p < 0.01).

Conclusions: Immediate physical feedback via treadmill belt acceleration can improve obstacle avoidance performance in a virtual environment. Future research is required to examine the generalizability of this finding to other populations and real-world falls.

Keywords: Accidental falls; Balance; Gait; Perturbations; Virtual reality.

MeSH terms

Accidental Falls* / prevention & control
Adult
Biomechanical Phenomena
Exercise Test
Feedback, Sensory*
Female
Gait
Humans
Male
Proof of Concept Study
Virtual Reality*
Walking* / physiology
Young Adult