Visual Dependence and Multisensory Balance Exercise
Condition: Visual Dependence; Multisensory; Exercise; Training; Balance; Elderly
Study type: Interventional

Summary: 
      The study aimed to investigate the effectiveness of multisensory balance training on the
      levels of visual dependence and sensory organization capacity in community-dwelling older
      adults. Participants in the experimental group received multisensory balance training while
      those in the control group received conventional balance training without sensory
      manipulation.
    

Detailed description: 
      Older people often find it difficult to maintain balance with their eyes closed, which
      emphasizes the importance of vision. The greater influence of vision on orientation and
      balance has been observed by manipulating static and dynamic visual cues-for instance,
      tilting the frame of reference or moving visual scenes. Older people-particularly those prone
      to falls-have been reported to make significantly greater errors in subjective visual
      verticality and exhibit greater sway and continued center of gravity oscillation during and
      following visual disturbances. They also adopted hip strategies to restore balance in
      response to visual perturbation, indicating that they were unstable in the event of visual
      disturbance. These results indicate that older people may have higher levels of visual
      dependence than younger adults.

      The underlying mechanism of visual dependence remains unclear. Visual dependence is
      considered a form of sensory reweighting deficit. In a situation of sensory conflict, the
      central nervous system must first recognize the discrepancy and reduce the weighting
      (suppress) of the inaccurate input while increasing the weighting of the input from the
      sensory systems that are deemed to provide more reliable information. This complex process of
      sensory organization is termed multiple-sensory reweighting and is vital in maintaining
      balance and orientation in a continuously changing and complex environment.

      Studies have suggested that visual dependence could benefit from promoting desensitization
      and increased visual motion tolerance through visual adaptation and habituation exercises in
      vestibular rehabilitation. This may be because the majority of visually dependent adults have
      the comorbid symptom of visual vertigo. However, according to the National Audit Survey in
      the United States, one-third of patients with vestibular disorders and visual dependence lack
      signs and symptoms of dizziness or vertigo. Recent evidence has demonstrated that healthy
      older adults with greater levels of visual dependence did not have dizziness; therefore, it
      is unclear whether visual adaptation exercises can effectively reduce the degree of visual
      dependence in such people. However, visual dependence can be considered as a sensory
      reweighting deficit; therefore, multisensory balance training with manipulation of the
      visual, vestibular, and proprioceptive inputs could be an alternative for decreasing visual
      dependence through improving the integration and reweighting of sensory systems. In fact,
      multiple studies have documented that multisensory balance training improves mobility and
      balance in older adults with instability or a history of falls; however, few have
      investigated its effectiveness on visual dependence and in healthy elderly people. Therefore,
      the aim of the study was to investigate the effectiveness of multisensory balance training on
      the levels of visual dependence and sensory organization capacity in older adults.
    

Intervention name(s): Multisensory balance exercise; Conventional balance exercise
Intervention type(s): Other; Other
Intervention description(s): Multisensory balance training describes a balance exercise incorporating individual sensory manipulation of vision, vestibular, proprioception and sensory integration.; such as static and dynamic standing balance without altered sensory inputs.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment