Can augmented feedback facilitate learning a reactive balance task among older adults?

Avril Mansfield, Anthony Aqui, Julia E. Fraser, Roshanth Rajachandrakumar, Bimal Lakhani, Kara K. Patterson

While concurrent augmented visual feedback of the center of pressure (COP) or center of gravity (COG) can improve quiet standing balance control, it is not known whether such feedback improves reactive balance control. Additionally, it is not known whether feedback of the COP or COG is superior. This study aimed to determine whether (1) concurrent augmented feedback can improve reactive balance control, and (2) feedback of the COP or COG is more effective. Forty-eight healthy older adults (60-75 years old) were randomly allocated to one of three groups: feedback of the COP, feedback of the COG, or no feedback. The task was to maintain standing while experiencing 30 s of continuous pseudo-random perturbations delivered by a moving platform. Participants completed 25 trials with or without feedback (acquisition), immediately followed by 5 trials without feedback (immediate transfer); 5 trials without feedback were completed after a 24-h delay (delayed transfer). The root mean square error (RMSE) of COP-COG, electrodermal level, and co-contraction index were compared between the groups and over time. All three groups reduced RMSE and co-contraction index from the start of the acquisition to the transfer tests, and there were no significant between-group differences in RMSE or co-contraction on the transfer tests. Therefore, all three groups learned the task equally well, and improved balance was achieved with practice via a more efficient control strategy. The two feedback groups reduced electrodermal level with practice, but the no-feedback group did not, suggesting that feedback may help to reduce anxiety.