VR could help improve balance in older people

As people grow older, losing balance and falling becomes more commonplace. This, in turn, increases the risk of injury and affects the person’s independence. Falls are the leading cause of non-fatal injuries in over 65-year-olds and account for over four million bed days per year in England alone, at an estimated cost of £2bn.

Over the years, experts have observed that humans use three ways of keeping their balance: vision, proprioceptive (physical feedback from muscles and joints), and vestibular system (feedback from semi-circular canals in the ear). Of these, vision is the most important.

Traditional ways of assessing balance include patient surveys and physical tests such as using a treadmill or testing agility when performing specific movements or exercises. But age, sex, and motivation can affect the accuracy of these tests, and the movements measured aren’t necessarily reflective of real-life scenarios.

To tackle this, several research studies have explored the use of VR to help assess balance and help train users to improve their balance.

Dr Pooya Soltani, from the University of Bath, and Renato Andrade, from the Clínica do Dragão, Espregueira-Mendes Sports Centre clinic in Portugal, reviewed data from 19 separate studies to investigate the validity, reliability, safety, feasibility, and efficacy of using head-mounted display systems for assessing and training balance in older adults.

Their research, with findings published in the journal Frontiers in Sports and Active Living, found that VR was effective in assessing balance and could be useful for fall prevention and for improving postural control and gait patterns. They also found these systems can differentiate healthy and balance-impaired individuals.

“Traditional tests for measuring balance can be inaccurate and sometimes unsafe – for example, if the patient is on a treadmill that stops suddenly,” said Dr Soltani, studio engineer at CAMERA, the University of Bath’s motion capture research centre.

“It may also be difficult to replicate real-life situations in a lab. But using VR opens up a huge range of scenarios that are more natural and relevant to the real world,” he added, using the example that experts can ask patients to cross a busy street and they can adapt these scenes easily to help them gradually improve their balance and build up confidence in their movement.

“Alternatively, VR could be used more like a video game where patients navigate virtually through a maze while doing additional cognitive tasks, like solving mathematical problems,” he explained further. “VR gives us the flexibility to add disorientating effects or resize and remove elements, to test how well participants maintain their balance.”

The researchers found that during VR versions of traditional balance tests, older adults generally gained a cautious behaviour and took more time to complete the tasks. However, the researchers observed they found them more enjoyable, which could help encourage participants to stick to a rehabilitation programme.

“Our review shows this technology has great potential, however, there is a lot of work to do before they can use it widely in rehabilitation,” Soltani concluded. “We need to check parameters such as altering frame rate, find which scenarios are most effective, and also reduce the problems some users experience with motion sickness when using VR.”

While Covid-19 has temporarily delayed plans to test the technology on volunteers, the researchers are now looking to recruit PhD students to define protocols and develop a robust system that users can test later in the year.