Comparing the effect of haptic modalities on walking balance control: Is using one or two arms better?

BACKGROUND

Adding haptic input by lightly touching a railing or using haptic anchors may improve walking balance control. Typical use of the railing(s) and haptic anchors requires the use of one and two arms in an extended position, respectively. It is unclear whether it is arm configuration and/or the number of arms used or the addition of sensory input that affects walking balance control.

RESEARCH QUESTION

This study examined whether using one arm or two arms to add haptic input through light touch on a railing or using the haptic anchors affects walking balance control.

METHODS

In this study, young adults (n = 24) walked while using (actual use) or pretending to use (pretend use) the railing(s) and haptic anchors with one or two arms. Inertial-based sensors (Mobility Lab, APDM) were used to measure stride velocity, relative time spent in double support (%DS), and peak normalized medio-lateral trunk velocity (pnMLTV).

RESULTS

Using two arms lead to a decrease in pnMLTV compared to using one arm and pnMLTV was lower in the actual use trials compared to the pretend use trials for the anchors only. Stride velocity and %DS did not change between trials when one or two arms were used or when participants actually or pretended to use the haptic tools. Participants walked slower when using the railing compared to the anchors.

SIGNIFICANCE

The importance of considering the number of arms is highlighted in the improved balance control when using two arms with either tool. The augmented sensory input adds to the stabilizing effect of arm configuration for the anchors but not the railings. These results have implications for future research and rehabilitation efforts emphasizing sensorimotor integration to improve walking balance control.

Multisensory factors in postural control: Varieties of visual and haptic effects

Background Previous work on balance control in children and adults highlights the importance of multisensory information. Work in this vein has examined two principal input sources - the role of visual and haptic information on balance. Recent work has explored the impact of a different form of haptic input - object holding - on balance in young infants. Research question This experiment examined the impact of simultaneous visual input and haptic input on balance in children and adults, employing two novel forms of haptic input. Methods Static balance was measured in 3-5 year olds, 7-9 year olds, and young adults, in the presence of all possible combinations of manipulated visual input (eyes open, eyes closed) and haptic input (no touch, object hold, touch an unstable support, touch a stable support). Results Analysis of postural stability (mean velocity) indicated that stability was influenced by visual input, haptic input, and age group. For visual input stability increased in eyes open versus eyes closed conditions. For haptic input, stability systematically increased with increasing levels of fixed haptic input (e.g., no touch, object hold, unstable touch, stable touch). Stability also increased as a function of increasing age group. There were no interactions between the factors. Significance The finding that the two novel forms of haptic input - object hold and touch with an unstable support surface - increased stability relative to no touch input, but not as much as touch with a stable support, indicates that children use haptic information in a self-referential fashion for controlling posture. The failure to observe any interactions between visual and haptic inputs with age suggests that multisensory processing is generally additive across development, and has implications for the occurrence of sensory weighting across developmental epochs.

The effects of haptic input on biomechanical and neurophysiological parameters of walking: A scoping review

Walking is an important component of daily life requiring sensorimotor integration to be successful. Adding haptic input via light touch or anchors has been shown to improve standing balance; however, the effect of adding haptic input on walking is not clear. This scoping review systematically summarizes the current evidence regarding the addition of haptic input on walking in adults. Following an established protocol, relevant studies were identified using indexed data bases (Medline, EMBASE, PsychINFO, Google Scholar) and hand searches of published review articles on related topics. 644 references were identified and screened by a minimum of two independent researchers before data was extracted from 17 studies. A modified TREND tool was used to assess quality of the references which showed that the majority of studies were of moderate or high quality. Results show that adding haptic input changes walking behaviour. In particular, there is an immediate reduction in variability of gait step parameters and whole body stability, as well as a decrease in lower limb muscle activity. The effect of added haptic input on reflex modulation may depend on the limb of interest (i.e., upper or lower limb). Many studies did not clearly describe the amount and/or direction of haptic input applied. This information is needed to replicate and/or advance their results. More investigations into the use and design of the haptic tools, the attentional demands of adding haptic input, and clarity on short-term effects are needed. In addition, more is research needed to determine whether adding haptic input has significant, lasting benefits that may translate to fall prevention efforts.

Effect and immediate after-effect of lightly gripping the cane on postural sway

Background

This study investigated the effect and after-effect of lightly touching a real cane on postural sway and ankle muscle activity.

Method

Participants performed a single-leg stance (SLS) task with their eyes closed for 30 s under three tasks. In the first and third tasks, the participants performed a normal SLS. In the second task, the participants in light-grip group (n = 11) were asked to perform SLS while lightly gripping a cane with their hand. The participants in depend-on-cane group (n = 11) were asked to support their own body with a cane.

Results

Postural sway during a single-leg stance is decreased by light gripping and is accompanied by decreased co-contraction of the ankle-joint muscles. If a participant lightly gripped a cane, postural sway decreased not only during the light gripping but also immediately after the withdrawal of the cane. Although postural sway and co-contraction in the depend-on-cane group were significantly decreased during the second task compared to the first task, they were not significantly changed between the first and third tasks.

Conclusion

These results suggest that lightly gripped cane provides a haptic sensory cue that can be used to assist postural control mechanisms due to enhanced perception of self-motion through sensory interaction with the environment through the cane. Further, the haptic sensory cue during postural maintenance might be promoted as a practice effect of postural control.