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Adults (N = 54, 80.78 ± 6.08 years) who reported falling during the previous 12 months participated in a 12-week wobble board training program with internal focus or external focus (EF) instructions. Verbal manipulation checks were performed after training sessions as a self-report of the attentional foci used. The percentage of sessions in which participants reported using an EF (EFSR) was subsequently calculated. Mean velocity and mean power frequency in the anterior–posterior (MVELOAP and MPFAP) and medial–lateral (MVELOML and MPFML) direction were assessed during a 35-s wobble board task at Weeks 0, 6, 12, 13, 16, and 20, with the latter three as retention tests. Piecewise linear growth models estimated treatment effects on individual growth trajectories of MVELOAP and ML and MPFAP and ML during intervention and retention periods. Regardless of condition, MVELOML significantly decreased (π = −.0019, p =.005) and MPFML increased (π =.025, p <.02) during the intervention period. In analyses including interaction terms, participants in the EF group who reported greater EFSR had superior progression of MPFAP during the intervention (π =.0013, p =.025). Verbal manipulation checks suggest a preference for and advantage of EF for facilitating postural control performance and automaticity. [ABSTRACT FROM AUTHOR]

Obstacle crossing, such as stepping over a curb, becomes more challenging with natural aging and could lead to obstacle-related trips and falls. To reduce fall-risk, obstacle training programs using physical obstacles have been developed, but come with space and human resource constraints. These barriers could be removed by using a virtual obstacle crossing training program, but only if the learned gait characteristics transfer to a real environment. We examined whether virtual environment obstacle crossing behavior is transferred to crossing real environment obstacles. Forty participants (n = 20 younger adults and n = 20 older adults) completed two sessions of virtual environment obstacle crossing, which was preceded and followed by one session of real environment obstacle crossing. Participants learned to cross the virtual obstacle more safely and that change in behavior was transferred to the real environment via increased foot clearance and alterations in foot placement before and after the real environment obstacle. Further, while both age groups showed transfer to the real environment task, they differed on the limb in which their transfer effects applied. This suggests it is plausible to use virtual reality training to enhance gait characteristics in the context of obstacle avoidance, potentially leading to a novel way to reduce fall-risk. [ABSTRACT FROM AUTHOR]

Obstacle crossing, such as stepping over a curb, becomes more challenging with natural aging and could lead to obstacle-related trips and falls. To reduce fall-risk, obstacle training programs using physical obstacles have been developed, but come with space and human resource constraints. These barriers could be removed by using a virtual obstacle crossing training program, but only if the learned gait characteristics transfer to a real environment. We examined whether virtual environment obstacle crossing behavior is transferred to crossing real environment obstacles. Forty participants (n = 20 younger adults and n = 20 older adults) completed two sessions of virtual environment obstacle crossing, which was preceded and followed by one session of real environment obstacle crossing. Participants learned to cross the virtual obstacle more safely and that change in behavior was transferred to the real environment via increased foot clearance and alterations in foot placement before and after the real environment obstacle. Further, while both age groups showed transfer to the real environment task, they differed on the limb in which their transfer effects applied. This suggests it is plausible to use virtual reality training to enhance gait characteristics in the context of obstacle avoidance, potentially leading to a novel way to reduce fall-risk. [ABSTRACT FROM AUTHOR]