The Influence of Proprioceptive Training with the Use of Virtual Reality on Postural Stability of Workers Working at Height

Effects of virtual heights, dual-tasking, and training on static postural stability

Working at altitudes, dual-tasking (DT), and lack of experience cause falls. This study aimed to investigate the impact of virtual heights, DT, and training on static postural stability. Twenty-eight volunteers' balance at seven virtual environments [VE; ground (G), altitude 1 (A1), edge 1 (E1), altitude 2 (A2), edge 2 (E2), altitude 3 (A3), and edge 3 (E3)] were recorded during single-tasking (ST) and DT over three days. Independent variables were analyzed using a 7 (VE) x 3 (DAY) x 2 (TASK) factorial repeated measures ANOVA. Greater postural sway was observed in A3 and E1, on DAY 1, and during DT. The study demonstrated static postural stability deteriorates at higher virtual altitudes and during DT and improves with training. The findings of the study suggest that virtual reality is a great altitude simulator, which could be used as a potential balance training tool in ergonomic settings.

Development and Application of a Stability Index Estimation Algorithm Based on Machine Learning for Elderly Balance Ability Diagnosis in Daily Life

BACKGROUND

The stability index estimation algorithm was derived and applied to develop and implement a balance ability diagnosis system that can be used in daily life.

METHODS

The system integrated an approach based on sensory function interaction, called the clinical test of sensory interaction with balance. A capacitance and resistance sensing type force mat was fabricated, and a stability index prediction algorithm was developed and applied using the center of pressure variables. The stability index prediction algorithm derived a center of pressure variable for 103 elderly people by Nintendo Wii Balance Board to predict the stability index of the balance system (Biodex SD), and the accuracy of this approach was confirmed.

RESULTS

As a result of testing with the test set, the linear regression model confirmed that the r-value ranged between 0.943 and 0.983. To confirm the similarity between the WBB and the flexible force mat, each measured center of pressure value was inputted and calculated in the developed regression model, and the result of the correlation coefficient validation confirmed an r-value of 0.96.

CONCLUSION

The system developed in this study will be applicable to daily life in the home in the form of a floor mat.

Improvement of short-term outcomes with VR-based safety training for work at heights

Serious games and virtual reality offer engaging learning opportunities and a cost-effective solution within an immersive and safe environment for safety training in construction. However, there have been few examples of safety training for work at heights developed using these technologies, especially commercial training. To fill this literature gap, a new VR-based safety training was developed and compared with lecture-based training across time. We conducted a quasi-experiment with a non-equivalent group design with 102 workers from six construction sites in Colombia. Learning objectives, observations from training centers, and national regulations were considered during the design of the training methods. Training outcomes were assessed using Kirkpatrick's model. We found that both training approaches were effective in improving knowledge test results and self-reported attitudes in the short-term; and risk-perception, self-reported behavior and safety climate in the long-term. In particular, participants of the VR-based training got significantly higher results in knowledge and reported higher attitudes (commitment and motivation) than participants of the lecture-based training. We suggest that safety managers and practitioners should invest in VR using serious games as an alternative to training programs based on short-term outcomes. Future work is needed to test VR for long-term outcomes.

Somatosensory Information in Skilled Motor Performance: A Narrative Review

Historically, research aimed at improving motor performance has largely focused on the neural processes involved in motor execution due to their role in muscle activation. However, accompanying somatosensory and proprioceptive sensory information is also vitally involved in performing motor skills. Here we review research from interdisciplinary fields to provide a description for how somatosensation informs the successful performance of motor skills as well as emphasize the need for careful selection of study methods to isolate the neural processes involved in somatosensory perception. We also discuss upcoming strategies of intervention that have been used to improve performance via somatosensory targets. We believe that a greater appreciation for somatosensation's role in motor learning and control will enable researchers and practitioners to develop and apply methods for the enhancement of human performance that will benefit clinical, healthy, and elite populations alike.

Effects of Low-Immersive vs. High-Immersive Exercise Environment on Postural Stability and Reaction and Motor Time of Healthy Young Adults

(1) Background: Many young adults spend their time playing games and watching television. This type of spending time should be used effectively, so it's worth adding exercise and immersion to them. Bearing in mind that the video games and physical exercise also improve postural stability, motor time (MT) and reaction time (RT), it is worth reaching for new technologies with immersion that are widely available and can be used, for example, as a remote intervention. This study aimed to compare the effects of a low vs. high-immersive exercise environment on postural stability, RT and MT in young adults. (2) Methods: Ninety-three participants were randomly divided into a control group (CG; n = 48) and experimental group (EG; n = 45). The CG exercised according to the Tabata self-made video display on a television set, and the EG exercised according to the Audio Trip exergame. In addition to the postural stability, RT and MT, we monitored the heart rate, breath rate and energy expenditure for safety reasons and to note any differences. (3) Results: Significant differences were observed for both groups in RT (F(2.182) = 3.14, p = 0.046, η² = 0.03) and MT (F(2.182) = 3.07, p = 0.049, η² = 0.03) and in postural stability in eyes closed (EC): F(2.182) = 3.66, p = 0.028, η² = 0.04 and eyes open in one leg (EO-OL): F(2.182) = 5.814, p = 0.04, η² = 0.07. (4) Conclusions: The inclusion of a higher immersion produces greater improvements in RT, MT. Additionally, after a low-immersive exercise environment, participants have higher center of pressure (COP) path length values with EC and EO-OL tests, which testifies to less postural stability. Regarding COP trajectory, a smaller area surface means better performance for high-immersive participants after 30 min of exercise.

Critical Analysis of the Evaluation Methods of Extended Reality (XR) Experiences for Construction Safety

The construction industry has high accident rates. The sector is exploring various tools to improve safety management, training, and awareness to achieve zero accidents. This work focuses on extended reality (XR), which encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies. Several authors have developed training experiences for construction safety in XR environments with positive conclusions about their effectiveness. However, there is no standardization regarding the evaluation methods used in the sector, and many experiences do not use any method. This lack is critical, as whenever the aim is to evaluate the degree of awareness of security issues, the implementation of evaluation systems is indispensable to make known the methods used in the literature to evaluate the effectiveness of the experiences and represent support for future research. This research identifies developments in XR experiences and analyzes the validation methods through a systematic review using the PRISMA methodology. It identifies two evaluation methods, objective and subjective, which are each broken down into four categories. The results show the types of evaluation, safety-related purposes, and safety application objectives used by the database classification.

Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome

Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. This study aims to (1) assess cervical JPS and postural stability between FMS and control group and (2) determine the correlation between cervical JPS and postural stability in the FMS group. This cross-sectional study recruited 92 FMS patients (mean age: 51.52 ± 7.7 yrs.) and 92 healthy controls (mean age: 49.36 ± 6.9 yrs.). A cervical range of motion (CROM) unit was utilized to assess cervical JPS. The postural stability was assessed using an IsoFree force platform, and anterior-posterior (A/P) and medial-lateral (M/L) directions of sway and ellipse area were measured. Cervical JPS and postural stability tests were assessed and compared between FMS and control groups. Cervical JPS was significantly impaired in FMS compared to the control group (p < 0.001). The JPS errors in FMS group were larger in flexion (FMS = 5.5°, control = 2.4°), extension (FMS = 6.4°, control = 3.0°), and rotation in left (FMS = 5.4°, control = 2.2°) and right directions (FMS = 5.1°, control = 2.8°). FMS individuals demonstrated statistically significant impaired postural stability compared to control in both the dominant and non-dominant legs tested (p < 0.001). The cervical JPS test showed moderate to strong positive correlations with postural stability variables. Statistically significant correlations were observed in all the JPS directions tested with all the postural stability variables (A/P and M/L sway and ellipse area). The correlation coefficients ranged between r = 0.37 (moderate) to 0.75 (strong). Cervical JPS and postural stability are impaired in FMS individuals. A moderate to strong relationship existed between JPS and postural stability. Individuals with FMS who had a greater magnitude of cervical JPS errors exhibited more severe postural control deficits. Therefore, cervical JPS and postural stability tests should be incorporated into routine clinical practice when assessing or formulating treatment strategies for patients with FMS.

System Comparison for Gait and Balance Monitoring Used for the Evaluation of a Home-Based Training

There are currently no standard methods for evaluating gait and balance performance at home. Smartphones include acceleration sensors and may represent a promising and easily accessible tool for this purpose. We performed an interventional feasibility study and compared a smartphone-based approach with two standard gait analysis systems (force plate and motion capturing systems). Healthy adults (n = 25, 44.1 ± 18.4 years) completed two laboratory evaluations before and after a three-week gait and balance training at home. There was an excellent agreement between all systems for stride time and cadence during normal, tandem and backward gait, whereas correlations for gait velocity were lower. Balance variables of both standard systems were moderately intercorrelated across all stance tasks, but only few correlated with the corresponding smartphone measures. Significant differences over time were found for several force plate and mocap system-obtained gait variables of normal, backward and tandem gait. Changes in balance variables over time were more heterogeneous and not significant for any system. The smartphone seems to be a suitable method to measure cadence and stride time of different gait, but not balance, tasks in healthy adults. Additional optimizations in data evaluation and processing may further improve the agreement between the analysis systems.

Center of pressure-based postural sway differences on parallel and single leg stance in Olympic deaf basketball and volleyball players

In sports such as basketball and volleyball, loss of balance due to the inability to maintain body stability and lack of postural control adversely affect athletic performance. Deaf athletes appear to struggle with balance and postural stability problems. The purpose of this study was to examine postural sway values in parallel and single leg stance of Olympic deaf basketball and volleyball players and reveal differences between the branches. Twenty-three male athletes from the Turkish national deaf basketball (n=11) and volleyball (n=12) teams participated in the study. After anthropometric measurements, the subjects completed postural sway (PS) tests in parallel/single leg stances with open eyes and closed eyes on a force plate. PS parameters (sway path, velocity, and area) obtained from the device software were used for the statistical analysis. The Mann-Whitney U-test was used to compare differences in PS parameters between basketball and volleyball players, and the alpha value was accepted as 0.05. Volleyball players had significantly better results in parallel stance and dominant leg PS values than basketball players (P<0.05). There was no significant difference between the groups in nondominant leg PS values (P>0.05). We think that proprioceptive and vestibular system enhancing training practices to be performed with stability exercises will be beneficial in terms of both promoting functional stability and interlimb coordination. Trainers and strength coaches should be aware of differences in the postural control mechanism of deaf athletes.

The effectiveness of virtual safety training in work at heights: A literature review

Virtual environment techniques are technologies that can be used for safety training, and deliver significant advantages (e.g. risk-free, immersive learning). However, no studies have assessed the effectiveness of this training for work at heights (WAH). This paper aimed to synthesize the outcomes criteria for measuring the effectiveness of virtual safety training of WAH in different work sectors. A total of 658 records were identified through an explorative search of relevant citations from 2010 onwards. Only 21 documents were considered and classified according to the training goal: improvement of knowledge, skills or attitudes. Outcomes criteria of virtual safety training were analyzed according to Kirkpatrick's model. The results support practitioners and safety managers by providing an inventory of training methods, evaluation indicators and evaluation effects. Further recommendations are made for the design of an effective training assessment.

The Influence of Walking Height and Width on the Gait

Walking stability is an important factor that is related to working accidents at height. The understanding of the relationship between walking stability and walking conditions remains an unmet need. Therefore, this study aimed to investigate the effect of path height, width, and asymmetric conditions on the pressure and time information of the foot-ground interaction during walking. 12 subjects were required to walk at two height, three width, and asymmetric conditions. Plantar pressures during walking were measured with the F-scan insole sensors. The total pressures were normalized with body weight, and the temporal parameters were normalized with stance time. When the walking height increased, the plantar pressure at the "heel strike" phase did not change significantly, while that at "heel rise" and "toe off" phases significantly increased, and the "heel rise" occurred earlier, indicating a greater foot-ground interaction at the forefoot part of the sole. As the path width increased from 0.6 m to 1.2 m, the foot-ground interaction as well as the asymmetric effect approached to that of overground walking. The findings could help improve the risk assessment and footwear design.

Factors for the Automation of the Creation of Virtual Reality Experiences to Raise Awareness of Occupational Hazards on Construction Sites

Two of the differential characteristics of the AECO sector (architecture, engineering, construction and operation) are barriers for the mass creation of training materials for its workers. On the one hand, the workplace is unique and changing over time; on the other, the aging trend of its workers and the unattractive nature of the industry for new generations of professionals. These two problems can be tackled by virtual reality technologies, which allow the agile creation of all kinds of scenarios, while their current technology may be attractive to young people and intuitive for everyone. This work shows the results of an investigation that seeks to provide automated tools based on virtual reality experiences to support learning in occupational risk prevention. This objective is part of the development of a culture for prevention, which allows the treatment of the human factor, with all its complexity and casuistry. The proposal includes the development of a process and tools that allow replicating the specific scenario where the work will be carried out, incorporating risks and probable incidents, systematically establishing cause-effect relationships, incorporating a narrative (storytelling) that provides emotional meaning to users and Lastly, the creation of a workflow that facilitates the agile development of these virtual reality experiences for each specific work.

Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

More innovative technologies are used worldwide in patient's rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen's d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen's d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen's d 0.693), muscle strength (p < 0.05, Cohen's d 0.924), lower extremity functionality (p < 0.05, Cohen's d 0.984) and postural balance (p < 0.05, Cohen's d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

Virtual Reality as a Portable Alternative to Chromotherapy Rooms for Stress Relief: A Preliminary Study

Chromotherapy rooms are comfortable spaces, used in places like special needs schools, where stimuli are carefully selected to cope with stress. However, these rooms are expensive and require a space that cannot be reutilized. In this article, we propose the use of virtual reality (VR) as an inexpensive and portable alternative to chromotherapy rooms for stress relief. We recreated a chromotherapy room stress relief program using a commercial head mounted display (HD). We assessed the stress level of two groups (test and control) through an EEG biomarker, the relative gamma, while they experienced a relaxation session. First, participants were stressed using the Montreal imaging stress task (MIST). Then, for relaxing, the control group utilized a chromotherapy room while the test group used virtual reality. We performed a hypothesis test to compare the self- perceived stress level at different stages of the experiment and it yielded no significant differences in reducing stress for both groups, during relaxing (p-value: 0.8379, α = 0.05) or any other block. Furthermore, according to participant surveys, the use of virtual reality was deemed immersive, comfortable and pleasant (3.9 out of 5). Our preliminary results validate our approach as an inexpensive and portable alternative to chromotherapy rooms for stress relief.

Human and Animal Motion Tracking Using Inertial Sensors

Motion is key to health and wellbeing, something we are particularly aware of in times of lockdowns and restrictions on movement. Considering the motion of humans and animals as a biomarker of the performance of the neuro-musculoskeletal system, its analysis covers a large array of research fields, such as sports, equine science and clinical applications, but also innovative methods and workplace analysis. In this Special Issue of Sensors, we focused on human and animal motion-tracking using inertial sensors. Ten research and two review papers, mainly on human movement, but also on the locomotion of the horse, were selected. The selection of articles in this Special Issue aims to display current innovative approaches exploring hardware and software solutions deriving from inertial sensors related to motion capture and analysis. The selected sample shows that the versatility and pervasiveness of inertial sensors has great potential for the years to come, as, for now, limitations and room for improvement still remain.