Relative efficacy of various strategies for visual feedback in standing balance activities

Seventy-nine young, healthy adults were led through static balance and weight-shifting activities in order to study the effects of visual feedback on balance. Based on their performance, the relative effects of various feedback properties were analyzed: (1) arrangement [direct center of pressure (CoP) vs. lateral weight distribution feedback], (2) numbers (presence vs. absence of numeric feedback), and (3) dimensionality (1D vs. 2D CoP information). In the static balance activity, subjects were instructed to maintain equal weight across both feet; in the dynamic weight-shifting activity, subjects were instructed to shift their weight to each displayed target location. For static balance, lateral symmetry and sway were measured by classical parameters using CoP, center of gravity (CoG), and the difference between the two (CoP-CoG). Weight-shifting balance performance was measured using the time required to shift between target CoP positions. Results indicated that feedback arrangement had a significant effect on static sway and dynamic weight shifting, with direct CoP feedback resulting in better balance performance than lateral weight distribution. Also, numbers had a significant effect on static sway, reducing lateral sway compared to feedback without numbers. Finally, 2D CoP feedback resulted in faster performance than 1D CoP feedback in dynamic weight shifting. These results show that altering different properties of visual feedback can have significant effects on resulting balance performance; therefore, proper selection of visual feedback strategy needs to take these effects into consideration.