Modulation of body sway after virtual height exposure in older adults with different levels of fear of falling: a cross-sectional observational study

Abstract

Introduction: The elderly population is growing rapidly all over the world, and the alterations that encompass biological, social, and psychological aspects that characterize this phase of life can evolve to cognitive and sensorimotor declines, culminating mainly in a greater risk of falls. A risk factor for falls that needs further investigation in the elderly population is the fear of falling, since it is considered an emotional trait that causes changes in body balance strategies. Immersive Virtual Reality (IVR) is a tool that has been used in the field of Physical Therapy for evaluative, preventive and rehabilitation purposes, providing realistic experiences in safe and controlled environments, and was used in this research to investigate whether the virtual experience of great heights influences the postural balance control of elderly people with different degrees of fear of falling, in view of the different results recorded in the literature on the influence of the stressor agent height on the body balance control in different adapted individuals, except for the elderly. Objective: To investigate whether there are differences in the modulation of body sway in elderly people with varying levels of fear of falling after exposure to virtual height. Methods: Thirteen elderly people were included in this pilot applicability study of the cross-sectional observational, descriptive-analytical type. A Virtual Reality (VR) Head Mounted Display (HMD) was used for virtual height exposure. Body sway was recorded with an accelerometer built into a smartphone positioned on the lower back of the participants, before and after virtually standing on a wooden plank 80 stories high. Fear of falling was accessed with the Falls Efficacy Scale-International (FES-I)-Brazil instrument. Results: There was an overall increase in sway after exposure to virtual height (ANOVA’s P<0.038, 2>0.114), regardless of the level of fear of falling (P>0.114). There was no correlation between body sway measurements and FES-I-Brazil scores (Pearson's analysis P>0,089). Conclusion: Exposure to height with VR HMD modified the body sway of elderly people, regardless of their levels of fear of falling, suggesting that this type of exposure can be used for physical therapy clinical evaluation and monitoring of the performance of balance control systems in training programs. rehabilitation and prevention of falls in the elderly population.