What is the most effective type of audio-biofeedback for postural motor learning?

Department of Applied Mechanics, Chalmers University of Technology, SAFER - Box 8077 - S-402 78 - Göteborg, Sweden.
Gait & posture (Impact Factor: 2.75). 06/2011; 34(3):313-9. DOI: 10.1016/j.gaitpost.2011.05.016
Source: PubMed


Biofeedback is known to improve postural control and reduce postural sway. However, the effects that different biofeedback modes (coding for more or less complex movement information) may have on postural control improvement are still poorly investigated. In addition, most studies do not take into account the effects of spontaneous motor learning from repetition of a task when investigating biofeedback-induced improvement in postural control. In this study, we compared the effects of four different modes of audio-biofeedback (ABF), including direction and/or magnitude of sway information or just a non-specific-direction alarm, on the postural sway of 13 young healthy adults standing on a continuously rotating surface. Compared to the non-specific-direction alarm, ABF of continuous postural sway direction and/or amplitude resulted in larger postural sway reduction in the beginning of the experiment. However, over time, spontaneous postural motor learning flattened the effects of the different modes of ABF so that the alarm was as effective as more complex information about body sway. Nevertheless, motor learning did not make ABF useless, since all modes of ABF further reduced postural sway, even after subjects learned the task. All modes of ABF resulted in improved multi-segmental control of posture and stabilized the trunk-in-space. Spontaneous motor learning also improved multi-segmental control of posture but not trunk-in-space stabilization as much as ABF. In conclusion, although practice standing on a perturbing surface improved postural stability, the more body sway information provided to subjects using ABF, the greater the additional improvement in postural stability.

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    • "One of the main problems associated with locomotion instability in older individuals is the increased risk for falls [10]. Some studies have shown that, when deficits of a sensory system impair postural control, the addition of sensory information from another input system (e.g., tactile, auditory, or visual biofeedback) can help to improve body stability by reducing trunk sway [11] [12]. "
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    ABSTRACT: This study assessed whether the use of an "anchor system" benefited older adults who performed a tandem walking task. Additionally, we tested the effects of practice with the anchor system during walking on trunk stability, in the frontal plane, of older adults. Forty-four older adults were randomly assigned to three groups: control group, 0g anchor group, and 125g anchor group. Individuals in each group performed a tandem walking task on the GaitRite system with an accelerometer placed on the cervical region. The participants in the 125g anchor group held, in each hand, a flexible cable with a light mass attached at the end of the cable, which rested on the ground. The individuals kept the mass in contact with the ground and pulled on the cable just enough to keep it taught. The 0g anchor group held an anchor tool without any mass attached to the end portion. The results of this study demonstrated that the use of the anchor system contributed to the reduction of trunk acceleration in the frontal plane. However, this effect did not persist after removal of the anchors, which suggests that the amount of practice with this tool was insufficient to generate any lasting effect, or that the task was not sufficiently challenging, or both.
    Full-text · Article · Oct 2015 · Neuroscience Letters
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    • "Non-supportive light touch can also substitute as an earth vertical reference point and stabilize posture (Creath et al., 2002, 2008). Auditory biofeedback has also been used as a form of vestibular sensory substitution by notifying patients about the degree of postural sway through auditory cues (Dozza et al., 2007, 2011). "
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    ABSTRACT: Bilateral loss of vestibular inputs affects far fewer patients than unilateral inner ear damage, and thus has been understudied. In both animal subjects and human patients, bilateral vestibular hypofunction (BVH) produces a variety of clinical problems, including impaired balance control, inability to maintain stable blood pressure during postural changes, difficulty in visual targeting of images, and disturbances in spatial memory and navigational performance. Experiments in animals have shown that non-labyrinthine inputs to the vestibular nuclei are rapidly amplified following the onset of BVH, which may explain the recovery of postural stability and orthostatic tolerance that occurs within 10 days. However, the loss of the vestibulo-ocular reflex and degraded spatial cognition appear to be permanent in animals with BVH. Current concepts of the compensatory mechanisms in humans with BVH are largely inferential, as there is a lack of data from patients early in the disease process. Translation of animal studies of compensation for BVH into therapeutic strategies and subsequent application in the clinic is the most likely route to improve treatment. In addition to physical therapy, two types of prosthetic devices have been proposed to treat individuals with bilateral loss of vestibular inputs: those that provide tactile stimulation to indicate body position in space, and those that deliver electrical stimuli to branches of the vestibular nerve in accordance with head movements. The relative efficacy of these two treatment paradigms, and whether they can be combined to facilitate recovery, is yet to be ascertained.
    Full-text · Article · Dec 2011 · Frontiers in Neurology
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    ABSTRACT: This study evaluated the effects of interactive video-game based (IVGB) training on the balance of older adults. The participants of the study included 30 community-living persons over the age of 65. The participants were divided into 2 groups. Group A underwent IVGB training for 6 weeks and received no intervention in the following 6 weeks. Group B received no intervention during the first 6 weeks and then participated in training in the following 6 weeks. After IVGB intervention, both groups showed improved balance based on the results from the following tests: the Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), Timed Up and Go (TUG) test, and the Sway Velocity (SV) test (assessing bipedal stance center pressure with eyes open and closed). Results from the Sway Area (SA) test (assessing bipedal stance center pressure with eyes open and closed) revealed a significant improvement in Group B after IVGB training. Group A retained some training effects after 6 weeks without IVGB intervention. Additionally, a moderate association emerged between the Xavix measured step system stepping tests and BBS, MFES, Unipedal Stance test, and TUG test measurements. In conclusion, IVGB training improves balance after 6 weeks of implementation, and the beneficial effects partially remain after training is complete. Further investigation is required to determine if this training is superior to traditional physical therapy.
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