Can Virtual Reality Help Us Prevent Falls in the Elderly and Others?

Every year, falls lead to hospitalization or death for hundreds of thousands of elderly Americans. Standard clinical techniques generally cannot diagnose balance impairments before they lead to falls. But researchers from the University of North Carolina at Chapel Hill and North Carolina State University have found evidence that virtual reality (VR) could be a big help - not only for detecting balance impairments early, but perhaps also for reversing those impairments and preventing falls.

In a study published in Nature Scientific Reports, a research team led by Jason R. Franz, PhD, assistant professor in the Joint UNC/NC State department of biomedical engineering, used a novel VR system to create the visual illusion of a loss of balance as study participants walked on a treadmill. By perturbing their sense of balance in this way and recording their movements, Franz's team was able to determine how the participants' muscles responded. In principle, a similar setup could be used in clinical settings to diagnose balance impairments, or even to train people to improve their balance while walking.

"We were able to identify the muscles that orchestrate balance corrections during walking," Franz said. "We also learned how individual muscles are highly coordinated in preserving walking balance. These things provide an important roadmap for detecting balance impairments and the risk of future falls."

Young and healthy adults rely predominantly on the mechanical "sensors" in their feet and legs to give them an accurate sense of body position. So, healthy people usually have no trouble walking in the dark or with their eyes closed. But this sense of proprioception declines in the elderly, as well as in people who have neurodegenerative diseases, such as multiple sclerosis, leading to a much greater reliance on visual cues to maintain balance. In their study, Franz and colleagues chose to use a VR-based method to perturb the visual perception of balance. The subjects walked on a treadmill in front of a large, curved screen depicting a moving hallway.

"As each person walked, we added lateral oscillations to the video imagery, so that the visual environment made them feel as if they were swaying back and forth, or falling," Franz said. "The participants know they aren't really swaying, but their brains and muscles automatically try to correct their balance anyway."

In a setup like those seen in Hollywood motion-capture animation studios, Franz and his team used 14 cameras to record the positions of 30 reflecting markers on the legs, back, and pelvis of each subject. This allowed them to see, in detail, how the specific muscle groups that control postural sway and foot placement worked to correct a perceived loss of balance.

In response to the visual perturbations, the subjects took wider and shorter steps, as expected. And their head and trunk swayed further sideways with each step. The variability of these measures - their tendency to change from one step to the next - increased much more strikingly. Electrodes attached to the skin of the subjects also revealed coordinated electrical activity among the muscles that control postural sway and foot placement, including the gluteus medius, external oblique, and erector spinae.

"These findings give us important insights into the detailed mechanisms of walking balance control," Franz said.

The data also provide key reference measurements that could be used in future clinical procedures to detect balance impairments before they cause people to fall. Franz and his team have ongoing studies in elderly people and plans for studies in people with multiple sclerosis to help develop early-detection procedures. In their earlier work, they have shown that using this VR setting can identify age-related balance deficits that are not otherwise apparent during normal walking.

"We think there's a big opportunity to use visual perturbations in a VR setting to reveal balance impairments that would not be detected in conventional testing or normal walking," Franz said. "The key is to challenge balance during walking, to tease out those impairments that exist under the surface."

Franz and his colleagues also are examining the potential of their VR setup as a physical therapy tool to teach balance-impaired people how to improve their balance and avoid falls. "Early work in our lab suggests it's possible to use these visual perturbations to train a person's balance control system to respond better to imbalance that occurs in daily living," Franz said.

The National Center for Advancing Translational Sciences funded this research.

Stokes HE, Thompson JD, Franz JR.
The Neuromuscular Origins of Kinematic Variability during Perturbed Walking.
Sci Rep. 2017 Apr 11;7(1):808. doi: 10.1038/s41598-017-00942-x.

Most Popular Now

Virtual Humans Help Aspiring Doctors Lea…

For medical student Katie Goldrath, the first time delivering difficult health news came when she had to tell a young woman named Robin and her mom, Delmy, that Robin had...

Read more

'Smart Contact Lens Sensor' for Diabetic…

A recent study, affiliated with Ulsan National Institute of Science and Technology (UNIST), South Korea, has proposed the possibility of in situ human health monitoring simply by wearing a contact...

Read more

2017 eHealth Competition Awards SilverCl…

The eHealth Competition is an initiative that rewards the best digital health solutions produced by SMEs across Europe. This edition has been supported by Astrazeneca, Ship2B and Younoodle. This competition...

Read more

ECDC Report Shows Strong Potential of E-…

Twenty one EU/EEA countries have developed or are in the process of developing systems to digitally record information about vaccination, according to a new "ECDC survey report on immunisation information...

Read more

Devicare Raises 3 Million Euros in its C…

Devicare, a company specializing in innovative medical devices for chronic home care patients under Remote Patient Monitoring (RPM), has closed out a seed round of 3 million euros. This funding...

Read more

Successful Conclusion to conhIT 2017, th…

25 - 27 April 2017, Berlin, Germany. As conhIT, which took place from 25 to 27 April in Berlin, came to a close, 500 exhibitors, 9,500 participants from around the world...

Read more

Compiling Big Data in a Human-Centric Wa…

When a group of researchers in the Undiagnosed Disease Network at Baylor College of Medicine realized they were spending days combing through databases searching for information regarding gene variants, they...

Read more

Scopis Introduces the First Mixed-Realit…

Scopis, a company specializing in surgical navigation and medical augmented and mixed reality technologies, announced today the launch of its newest development, the Holographic Navigation Platform for use in surgery...

Read more

IMS MAXIMS Launches Vital Signs Mobile A…

Clinical technology specialist IMS MAXIMS will be launching its fully integrated vital signs application at eHealth Week on 3rd and 4th May in Olympia, London. Delegates will be the first...

Read more

Immunisation Information Systems in the …

Immunisation information systems (IIS) are defined as confidential, population-based, computerised databases that record all immunisation doses administered by participating providers to persons residing within a given geopolitical area. At the...

Read more

Abbott Announces CE Mark and First Use o…

Abbott (NYSE: ABT) today announced CE Mark and first use of the new Confirm RxTM Insertable Cardiac Monitor (ICM), the world's first smartphone compatible ICM that will help physicians identify...

Read more

Using a Smartphone to Screen for Male In…

More than 45 million couples worldwide grapple with infertility, but current standard methods for diagnosing male infertility can be expensive, labor-intensive and require testing in a clinical setting. Cultural and...

Read more