Virtual obstacle crossing and the clinical implications for rehabilitation

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Chanel T. LoJacono (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Christopher Rhea

Abstract: Fall risk is a concern for a variety of clinical populations, especially in lower-limb amputees. The risk of falling during walking is increased by an individual with pathology’s diminished ability for obstacle negotiation. Virtual obstacle crossing environments offer a rehabilitation technique that is space and material efficient and may enhance obstacle crossing skill acquisition and retention though the use of task specificity, repetition, and feedback; while presenting an engaging and motivating challenge for participants. Current literature has not determined the response of an individual to virtual obstacle crossing in comparison to real environment over-ground obstacle crossing, nor whether aging influences this behavior. In a first step to determine the clinical viability of a virtual reality obstacle crossing environment, this task was tested using healthy able-bodied individuals (20 younger adults and 20 older adults) to determine an individual’s expected crossing behavior during a single session of training. The purpose of this study was to (1) determine the biomechanical obstacle-crossing behavior of an able-bodied individual within a virtual environment, (2) determine if a learning effect exists with virtual obstacle crossing, and (3) determine if the learning effect will transfer to over-ground obstacle crossing and create performance changes. Dependent variables measured were foot placement before and after the obstacles for the both the lead and trail limbs, toe/heel clearance for both limbs in the vertical and radial directions, and the peak toe and heel elevation. The hypotheses were: (1) a training effect would be observed at the end of the virtual obstacle crossing training in the form of the adoption of a safer obstacle crossing strategy in the virtual environment, (2) a safer obstacle crossing strategy in the real environment would be adopted in the post-test relative to the pre-test, and (3) the performance changes in the virtual environment would be correlated with the performance changes in the real environment, suggesting an association between motor learning in a virtual environment and transfer to a real environment task. It was also postulated that each hypothesized finding would be affected by age, with older adults showing less learning and transfer (albeit still significant) compared to the younger adults. Results indicate that participants learned to cross the virtual obstacle more safely and that change in behavior was transfer to the real environment. Further, while both age groups showed transfer to the real environment task, they differed on which limb their transfer effects applied to. The data suggest it is plausible to use virtual reality training as a way to enhance gait characteristics in the context of obstacle avoidance, potentially a leading to a novel way to reduce fall risk.

Additional Information

Language: English
Date: 2016
Motor learning, Obstacle crossing, Virtual reality
Falls (Accidents) $x Prevention
Amputees $x Rehabilitation
Virtual reality in medicine

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