Differential effects of visual versus auditory biofeedback training for voluntary postural sway

Augmented sensory biofeedback training is often used to improve postural control. Our previous study showed that continuous auditory biofeedback was more effective than continuous visual biofeedback to improve postural sway while standing. However, it has also been reported that both discrete visual and auditory biofeedback training, presented intermittently, improves bimanual task performance more than continuous visual biofeedback training. Therefore, this study aimed to investigate the relative effectiveness of discrete visual biofeedback versus discrete auditory biofeedback to improve postural control. Twenty-two healthy young adults were randomly assigned to either a visual or auditory biofeedback group. Participants were asked to shift their center of pressure (COP) by voluntary postural sway forward and backward in line with a hidden target, which moved in a sinusoidal manner and was displayed intermittently. Participants were asked to decrease the diameter of a visual circle (visual biofeedback) or the volume of a sound (auditory biofeedback) based on the distance between the COP and the target in the training session. The feedback and the target were given only when the target reached the inflection points of the sine curves. In addition, the perceptual magnitudes of visual and auditory biofeedback were equalized using Stevens' power law. Results showed that the mean and standard deviation of the distance between COP and the target were reduced int the test session, removing the augmented sensory biofeedback, in both biofeedback training groups. However, the temporal domain of the performance improved in the test session in the auditory biofeedback training group, but not in the visual biofeedback training group. In conclusion, discrete auditory biofeedback training was more effective for the motor learning of voluntarily postural swaying compared to discrete visual biofeedback training, especially in the temporal domain.