Impact of using immersive virtual reality over time and steps in the Timed Up and Go test in elderly people

Abstract

Today, falls constitute a substantial health problem, especially in the elderly, and the diagnostic tests used by clinicians present often a low sensitivity and specificity. This is the case for the Timed Up and Go test which lacks contextualization with regard to everyday life limiting the relevance of its diagnosis. Virtual reality enables the creation of immersive, reproducible and secure environments, close to situations encountered in daily life, and as such could improve falling risk assessment. This study aims to evaluate the effect of immersive virtual reality by wearing a virtual reality headset with a non-disturbing virtual environment compared to real world on the Timed Up and Go test completion. Thirty-one elders (73.7 ± 9 years old) volunteered to participate in the study and the mean times and number of steps to complete a Timed Up and Go were compared in two conditions: actual-world clinical and virtual reality conditions. The results showed that the mean completion times and most of the mean number of steps of the Timed Up and Go in virtual reality condition were significantly different to those in clinical condition. These results suggest that there is a virtual reality effect and this effect is significantly correlated to the time taken to complete the Timed Up and Go. This information will be of interest to quantify the potential part of virtual reality effect on the motor control, measured in a virtual task using virtual controlled disturbances.

Does the Management of Visual and Audible Motion Information during an Immersive Virtual Reality Timed Up and Go Test Impact Locomotor Performance in the Elderly?

“…Regarding the comparison between the “real” condition and the “stable virtual reality” condition, the results coincide with those of our previous study [14], with an increase in the time and number of steps to perform the task. Now regarding the absence of significant differences observed between the 2 conditions in virtual reality, various factors may be involved.…”

“…Using virtual reality to contextualize a test environment to assess the risk of falls [13] requires an interest in motor changes induced by VR. In a previous study [14], we used the Timed Up and Go task [15] to compare the time and number of steps required to complete the task in real life and in a virtual environment simulating a real-life situation. The Timed Up and Go is a gold standard in fall risk assessment, and the task it offers, with a sit to stand, walk, turn around, and sit, is both relevant regarding daily activities that may indicate a risk of fall in the elderly but also for reproduction in a virtual environment.…”

The Influence of Virtual Reality Head-Mounted Displays on Balance Outcomes and Training Paradigms: A Systematic Review

“…These two studies showed that adding the HMD VR component to the TUG, the task was more challenging to complete and that the self-motion perceptions during the task changed. Muhla et al ( 2020 ) contextualized the traditional TUG to make it closer to the real-world scenarios. They observed an increase in the number of steps and the time to complete the VR TUG test.…”

“…These improvements are probably due to the challenges that are induced when using VR scenarios. While some researchers reported that older adults have similar balance performance in traditional and VR scenarios (Alahmari et al, 2014 ), others have argued that participants' behaviors in VR versions of balance tests differ significantly (Muhla et al, 2020 ). One explanation could be that HMD systems remove the surrounding visual cues that older adults require for maintaining balance.…”

“…It has been shown that participants generally walk slower, and their performance is lower in VR balance tests as compared to the traditional ones (Nyberg et al, 2006 ; Almajid et al, 2020 ). Participants also acquire more cautious behaviors when completing VR tasks in less secure VEs (Muhla et al, 2020 ) and take more time and steps which are adaptive strategies to ensure balance and avoid falling (Nyberg et al, 2006 ). Other strategies that healthy adults employed for increasing the stability in unfamiliar situations included a reduced forward displacement of whole-body CoM and lowered height of CoM (Thomas et al, 2016 ).…”