# Examining the Impact of Visual Perturbation Caused by Virtual Reality on Postural Stability

## TL;DR

This study shows how virtual reality environments can affect balance in young adults, offering a useful tool for balance training.

## Contribution

The study introduces new insights into how specific VR environments challenge postural control without causing simulator sickness.

## Key findings

- Virtual environments with accelerating and returning walls significantly increased postural sway variability.
- Maximum sway excursion and sway variability in the anterior-posterior axis were significantly altered.
- VR environments can simulate realistic visual disturbances for balance training without causing discomfort.

## Abstract

Application of virtual reality has gained traction as a promoting tool in rehabilitation techniques, particularly in the enhancement of postural balance. This study aimed to explore the effects of various virtual reality environments on the postural control of young adults. Twenty-five active collegiate students (14 females and 11 males) participated in this cross-sectional investigation. Participants experienced four distinct virtual environments: (1) a wall approaching at a constant speed, (2) a wall accelerating towards them, (3) a tilting wall, and (4) a wall that returns after tilting. Postural sway was assessed using a pedobarographic platform, and the center of pressure matrices was computed. A one-way repeated measures analysis of variance was conducted to analyze the postural sway metrics across the reference and the four experimental conditions. Significant alterations were detected in maximum sway excursion (p = 0.004), and sway variability (p < 0.001) in the anterior-posterior axis, as well as sway variability in the medial-lateral axis (p = 0.022). Pairwise comparisons indicated that the environments featuring the accelerating wall and the returning wall upon tilting produced the most significant changes. Conversely, maximum sway velocity and sway area variables did not exhibit significant changes in either direction. The findings suggest that virtual reality environments, particularly those simulating tilting or movement, considerably challenge postural control without inducing simulator sickness. Furthermore, virtual reality offers a cost-effective means to simulate realistic visual disturbances, which can be beneficial for designing balance training based on virtual reality like exergame therapies.