Author(s): WERTH, J., EPRO, G., WEBER, A., PLACIDO, M., HARTMANN, U., KARAMANIDIS, K., Institution: LONDON SOUTH BANK UNIVERSITY , Country: UNITED KINGDOM, Abstract-ID: 1241

INTRODUCTION:
The use of virtual reality (VR) in locomotor exercise is demonstrating potential for rehabilitating neuro-musculoskeletal disorders, with a focus on enhancing neuromuscular function during movement(1). However, to ensure these VR-acquired skills are beneficial for daily life locomotion, a deeper understanding of whether skills transfer in the physical world is necessary. This study aimed to explore the transfer and retention of locomotor adaptations and improvements in stability recovery from exercised tripping simulations and obstacle perturbations in VR to the physical world.
METHODS:
Fifty-two healthy adults, aged 20 to 34 years, were divided into two exercise groups: TRP, focusing on visually induced tripping simulations that involved tilts of the VR world around three axes, and OBS, involving sudden virtual obstacles on the treadmill, along with a control group undergoing unperturbed gait in VR. Subsequently (transfer), and one week later (retention) participants in the TRP group and controls were exposed to mechanically induced tripping during treadmill walking, while those in the OBS group and controls encountered a physical obstacle with similar dimensions to those in VR. Gait kinematics were analysed on both occasions using an optical motion capture system. Lower limb joint kinematics during the swing phase of recovery steps (tripping task) or crossing leg (obstacle crossing task) were compared between virtual and physical conditions using statistical parametric mapping. Performances and adaptations in locomotor safety and effectiveness were analysed by using the margin of stability (MoS; tripping) and toe clearance (obstacle crossing).
RESULTS:
Repeated exercise of visually induced tripping as well as obstacle simulations led to adaptive changes in lower extremity joint kinematics and enhanced performances, i.e. MoS increased on average by 5cm in TRP (p<0.05), and toe clearance decreased by 4.7cm in OBS (p<0.001).
During subsequent mechanically induced tripping, the TRP group revealed a higher MoS compared to controls (p<0.05), with no decline one week later. In contrast, the OBS group crossed physical obstacles with a lower toe clearance compared to controls but revealed significantly higher values compared to the VR condition (p<0.01).
CONCLUSION:
This studys findings indicate that adaptive changes in locomotor safety and effectiveness enhanced through repeated visual gait perturbations in virtual reality can partly be transferred and retained in physical scenarios. However, transferability appears to be constrained when navigating obstacles during walking, which may stem from a discrepancy in visual perception and motor response between virtual and physical environments. (1) Janeh & Steinicke, 2021, Front Hum Neurosci