Optimising the visual feedback technique for improving upright stance maintenance by delaying its display: behavioural effects on healthy adults.

The visual feedback technique (VFB) is recognized by several studies as a valuable tool for re-establishing the balance functions. However, one former study has highlighted the fact that the increased control induced by this technique infer both favourable (the amplitudes of the horizontal motions of the centre of gravity (CoG(h)) are diminished) and unfavourable features (the vertical difference between the CoG(h) motions and centre of pressure (CoP) trajectories are enhanced). One means to decrease these CoP-CoG(v) motions is to delay their display on the screen of the monitor. To assess these behavioural effects, 16 healthy adults were evaluated with various delays from 0 to 1200 ms. CoP displacements, measured through a force platform, were decomposed into two elementary motions: CoG(h) and the difference CoP-CoG(v). A fractional Brownian motion modelling of these motions allowed to determine from which distance and for how long the corrective process takes over and to what extent the motion is controlled. Compared to the VFB real time condition, increasing the delay induces some effects mainly on the CoP-CoG(v) motions which are largely diminished, the most striking effect appearing for delays exceeding 600 ms. Despite the lower forces these reduced amplitudes infer to control body sways, the amplitudes of the CoG(h) motions tend to increase slightly. Considered as a whole, whilst retaining the beneficial aspects of VFB without delay and significantly suppressing the unfavourable features, the data suggests that the method of delaying the screen display optimises the VFB technique.