Age-related differences in gait adaptations during overground walking with and without visual perturbations using a virtual reality headset

Abstract

Older adults have difficulty adapting to new visual information, posing a challenge to maintain balance during walking. Virtual reality can be used to study gait adaptability in response to discordant sensorimotor stimulations. This study aimed to investigate age-related modifications and propensity for visuomotor adaptations due to continuous visual perturbations during overground walking in a virtual reality headset. Twenty old and twelve young subjects walked on an instrumented walkway in real and virtual environments while reacting to antero-posterior and medio-lateral oscillations of the visual field. Mean and variability of spatiotemporal gait parameters were calculated during the first and fifth minutes of walking. A 3-way mixed-design ANOVA was performed to determine the main and interaction effects of group, condition and time. Both groups modified gait similarly, but older adults walked with shorter and slower strides and did not reduce stride velocity or increase stride width variability during medio-lateral perturbations. This may be related to a more conservative and anticipatory strategy as well as a reduced perception of the optic flow. Over time, participants adapted similarly to the perturbations but only younger participants reduced their stride velocity variability. Results provide novel evidence of age- and context-dependent visuomotor adaptations in response to visual perturbations during overground walking and may help to establish new methods for early identification and remediation of gait deficits.

Overground Walking in a Fully Immersive Virtual Reality: A Comprehensive Study on the Effects on Full-Body Walking Biomechanics

“…These scenarios potentially offer yet mostly unexplored possibilities for gait rehabilitation, such as training of activities of daily living ( Ahn and Hwang, 2019 ), obstacle crossing ( Weber et al, 2021 ), among other environments that might not easily or safely be replicated in clinical settings. VR also allows the studying of effects of various conditions which are usually difficult to evaluate such as visual impairments, dual tasks, or environmental effects like diffuse lighting conditions, crowded places, and different room sizes ( Almajid et al, 2020 ; Osaba et al, 2020 ; Taneda et al, 2021 ).…”

Investigating and acquiring motor expertise using virtual reality

“…VR could be used to design motor learning tasks of the requisite intermediate complexity better suited to longitudinal study. That said, despite increasing enthusiasm for VR as a research tool [38,39], tasks have largely remained simple and have cleaved close to their traditional 2-D counterparts (e.g., [40][41][42][43][44][45][46][47][48][49]). Only a handful of studies have attempted to utilize rich virtual environments to motor expertise in real-world complex tasks.…”

A Fully-Immersive Virtual Reality Setup to Study Gait Modulation

“…Fixed obstacles have the advantage of easier standardization across trials and subjects, but they may induce anticipation and pre-planning (Yamada et al, 2011 ) and do not allow adequate study of the gait modulation that occurs in an outdoor environment, where moving obstacles are prevalent (Sparrow and Tirosh, 2005 ). With respect to fixed obstacles, moving obstacles cause larger changes in the gait pattern (Gérin-Lajoie et al, 2005 ), requiring higher mental processing costs (Cutting et al, 1995 ; Gérin-Lajoie et al, 2005 ) and being more challenging for people at high risk of falling (Osoba et al, 2020 ). Gait pattern changes include both gait trajectory (Gérin-Lajoie et al, 2005 ; Cinelli and Patla, 2007 ; Basili et al, 2013 ; Olivier et al, 2013 ; Vassallo et al, 2017 ) and velocity (Cinelli and Patla, 2008 ; Basili et al, 2013 ; Olivier et al, 2013 ; Huber et al, 2014 ; Knorr et al, 2016 ).…”