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THE WALLS ARE CLOSING IN: POSTURAL RESPONSES TO A VIRTUAL CLAUSTROPHOBIC SIMULATION

Abstract

Sachini N K Kodithuwakku Arachchige1, Harish Chander1, Hannah Freeman1, Christopher Hill2, Christopher Hudson1, Alana Turner1, Adam Jones1, Adam Knight1. 1Mississippi State University, Starkville, MS. 2Northern Illinois University, DeKalb, IL.

BACKGROUND: Changes in the visual environment and therefore, the spatial orientation can induce postural instability that could lead to falls. Virtual reality (VR) has been used to expose individuals to virtual environments (VE) that increase postural threats. Claustrophobia is an anxiety disorder categorized under situational phobias and can induce postural threats in a VE. RESEARCH QUESTION: Can VR-generated claustrophobic simulation induce postural threats leading to postural instability? METHODS: Thirty healthy males and females (age: 20.7 ± 1.2 years; height: 166.5 ± 7.3 cm; mass: 71.7 ± 16.2 kg) were tested for postural stability while standing on a force platform upon exposure to five different testing trials that included a normal stance (No VR), stationary VE (VR), and three consecutive, randomly initiated, unexpected claustrophobia trials (CP1, CP2, CP3). The claustrophobia trials (CP1, CP2, CP3) involved all four walls closing in towards the center of the room. Center of pressure (COP) derived postural sway variables were analyzed with a one-way 1 × 5 [No VR × VR × CP1 × CP2 × CP3] repeated measures analysis of variance at an alpha level of 0.05. RESULTS & DISCUSSION: Significant main effect differences existed in all but one dependent COP-derived postural sway variable. Post-hoc pairwise comparisons with a Bonferroni correction revealed that postural sway excursions were significantly lower in claustrophobia trials than No VR and VR but only accomplished with significantly increased sway velocity, suggesting a bracing and co-contraction strategy when exposed to virtual claustrophobic postural threats. Additionally, postural sway decreased with subsequent claustrophobia trials, suggesting potential motor learning effects. CONCLUSIONS: Virtual claustrophobic simulations involving “the walls closing in” alter postural control responses in healthy young adults. These types of perturbations are susceptible to learning effects, which could serve as the basis for future interventions for those with claustrophobia in VR exposure therapy (VERT).

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