Visuomotor Adaptation Without Vision?

In 1995, an aftereffect following treadmill running was described, in which people would inadvertently advance when attempting to run in place on solid ground with their eyes closed. Although originally induced from treadmill running, the running-in-place aftereffect is argued here to result from the absence of sensory information specifying advancement during running. In a series of experiments in which visual information was systematically manipulated, aftereffect strength (AE), measured as the proportional increase (post-test/pre-test) in forward drift while attempting to run in place with eyes closed, was found to be inversely related to the amount of geometrically correct optical flow provided during induction. In particular, experiment 1 (n=20) demonstrated that the same aftereffect was not limited to treadmill running, but could also be strongly generated by running behind a golf-cart when the eyes were closed (AE=1.93), but not when the eyes were open (AE=1.16). Conversely, experiment 2 (n=39) showed that simulating an expanding flow field, albeit crudely, during treadmill running was insufficient to eliminate the aftereffect. Reducing ambient auditory information by means of earplugs increased the total distances inadvertently advanced while attempting to run in one place by a factor of two, both before and after adaptation, but did not influence the ratio of change produced by adaptation. It is concluded that the running-in-place aftereffect may result from a recalibration of visuomotor control systems that takes place even in the absence of visual input

Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. RESULTS: There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. SIGNIFICANCE: Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function

Forward optic flow is prioritised in visual awareness independently of walking direction

When two different images are presented separately to each eye, one experiences smooth transitions between them-a phenomenon called binocular rivalry. Previous studies have shown that exposure to signals from other senses can enhance the access of stimulation-congruent images to conscious perception. However, despite our ability to infer perceptual consequences from bodily movements, evidence that action can have an analogous influence on visual awareness is scarce and mainly limited to hand movements. Here, we investigated whether one's direction of locomotion affects perceptual access to optic flow patterns during binocular rivalry. Participants walked forwards and backwards on a treadmill while viewing highly-realistic visualisations of self-motion in a virtual environment. We hypothesised that visualisations congruent with walking direction would predominate in visual awareness over incongruent ones, and that this effect would increase with the precision of one's active proprioception. These predictions were not confirmed: optic flow consistent with forward locomotion was prioritised in visual awareness independently of walking direction and proprioceptive abilities. Our findings suggest the limited role of kinaesthetic-proprioceptive information in disambiguating visually perceived direction of self-motion and indicate that vision might be tuned to the (expanding) optic flow patterns prevalent in everyday life

Optic Flow Dominates Visual Scene Polarity in Causing Adaptive Modification of Locomotor Trajectory

Locomotion and posture are influenced and controlled by vestibular, visual and somatosensory information. Optic flow and scene polarity are two characteristics of a visual scene that have been identified as being critical in how they affect perceived body orientation and self-motion. The goal of this study was to determine the role of optic flow and visual scene polarity on adaptive modification in locomotor trajectory. Two computer-generated virtual reality scenes were shown to subjects during 20 minutes of treadmill walking. One scene was a highly polarized scene while the other was composed of objects displayed in a non-polarized fashion. Both virtual scenes depicted constant rate self-motion equivalent to walking counterclockwise around the perimeter of a room. Subjects performed Stepping Tests blindfolded before and after scene exposure to assess adaptive changes in locomotor trajectory. Subjects showed a significant difference in heading direction, between pre and post adaptation stepping tests, when exposed to either scene during treadmill walking. However, there was no significant difference in the subjects heading direction between the two visual scene polarity conditions. Therefore, it was inferred from these data that optic flow has a greater role than visual polarity in influencing adaptive locomotor function

Virtual reality-based assessment and rehabilitation of functional mobility

The advent of virtual reality (VR) as a tool for real-world training dates back to the mid-twentieth century and the early years of driving and flight simulators. These simulation environments, while far below the quality of today’s visual displays, proved to be advantageous to the learner due to the safe training environments the simulations provided. More recently, these training environments have proven beneficial in the transfer of user-learned skills from the simulated environment to the real world [5, 31, 48, 51, 57]. Of course the VR technology of today has come a long way. Contemporary displays boast high-resolution, wide-angle fields of view and increased portability. This has led to the evolution of new VR research and training applications in many different arenas, several of which are covered in other chapters of this book. This is true of clinical assessment and rehabilitation as well, as the field has recognized the potential advantages of incorporating VR technologies into patient training for almost 20 years [7, 10, 18, 45, 78]

The Effect of Virtual Reality on Gait Variability

Optic Flow (OF) plays an important role in human locomotion and manipulation of OF characteristics can cause changes in locomotion patterns. The purpose of the study was to investigate the effect of the velocity of optic flow on the amount and structure of gait variability. Each subject underwent four conditions of treadmill walking at their self-selected pace. In three conditions the subjects walked in an endless virtual corridor, while a fourth control condition was also included. The three virtual conditions differed in the speed of the optic flow displayed as follows – same speed (OFn), faster (OFf), and slower (OFs) than that of the treadmill. Gait kinematics were tracked with an optical motion capture system. Gait variability measures of the hip, knee and ankle range of motion and stride interval were analyzed. Amount of variability was evaluated with linear measures of variability - coefficient of variation, while structure of variability i.e., its organization over time, were measured with nonlinear measures - approximate entropy and detrended fluctuation analysis. The linear measures of variability, CV, did not show significant differences between Non-VR and VR conditions while nonlinear measures of variability identified significant differences at the hip, ankle, and in stride interval. In response to manipulation of the optic flow, significant differences were observed between the three virtual conditions in the following order: OFn \u3e OFf \u3e OFs. Measures of structure of variability are more sensitive to changes in gait due to manipulation of visual cues, whereas measures of the amount of variability may be concealed by adaptive mechanisms. Visual cues increase the complexity of gait variability and may increase the degrees of freedom available to the subject. Further exploration of the effects of optic flow manipulation on locomotion may provide us with an effective tool for rehabilitation of subjects with sensorimotor issues

Variability of Lower Extremity Joint Kinematics During Backward Walking in a Virtual Environment

Backward walking (BW) shows significant differences with forward walking (FW) and these differences are potentially useful in rehabilitation. However the lack of visual cues makes BW risky. The purpose of this study was to investigate the effect of visual cues provided by a virtual environment on FW and BW on gait variability. Each subject underwent four conditions of treadmill walking at self-selected pace. The subjects walked backwards in three conditions and forwards in the fourth condition. A virtual corridor was displayed to the subjects in the FW condition (forward optic flow) and two of the backward conditions (forward and backward optic flow). The third BW condition was a control condition (no visual cues). Gait variability measures of the hip, knee and ankle range of motion and the stride interval were analyzed. Magnitude of variability was evaluated with the coefficient of variation and structure of variability with approximate entropy. Significant differences were demonstrated between the FW and the BW gait characteristics as well as in gait variability (for both magnitude and structure of variability). No significant differences were found between the three BW conditions as a result of the direction of visual cues. In order to get optimal benefit of BW in the aged and the diseased, optical flow of visual feedback may need to be manipulated in a different manner than FW. Future studies will explore other parameters of visual cues like the velocity of optic flow and appearance of obstacles to obtain the best visual cue configuration for rehabilitation

The Influence of Visual Perception of Self-Motion on Locomotor Adaptation to Unilateral Limb Loading

Self-perception of motion through visual stimulation may be important for adapting to locomotor conditions. Unilateral limb loading is a locomotor condition that can improve stability and reduce abnormal limb movement. In the present study, the authors investigated the effect of self-perception of motion through virtual reality (VR) on adaptation to unilateral limb loading. Healthy young adults, assigned to either a VR or a non-VR group, walked on a treadmill in the following 3 locomotor task periods—no load, loaded, and load removed. Subjects in the VR group viewed a virtual corridor during treadmill walking. Exposure to VR reduced cadence and muscle activity. During the loaded period, the swing time of the unloaded limb showed a larger increase in the VR group. When the load was removed, the swing time of the previously loaded limb and the stance time of the previously unloaded limb showed larger decrease and the swing time of the previously unloaded limb showed a smaller increase in the VR group. Lack of visual cues may cause the adoption of cautious strategies (higher muscle activity, shorter and more frequent steps, changes in the swing and stance times) when faced with situations that require adaptations. VR technology, providing such perceptual cues, has an important role in enhancing locomotor adaptation