Head-Mounted and Hand-Held Displays Diminish the Effectiveness of Fall-Resisting Skills

Use of head-mounted displays (HMDs) and hand-held displays (HHDs) may affect the effectiveness of stability control mechanisms and impair resistance to falls. This study aimed to examine whether the ability to control stability during locomotion is diminished while using HMDs and HHDs. Fourteen healthy adults (21-46 years) were assessed under single-task (no display) and dual-task (spatial 2-n-back presented on the HMD or the HHD) conditions while performing various locomotor tasks. An optical motion capture system and two force plates were used to assess locomotor stability using an inverted pendulum model. For perturbed standing, 57% of the participants were not able to maintain stability by counter-rotation actions when using either display, compared to the single-task condition. Furthermore, around 80% of participants (dual-task) compared to 50% (single-task) showed a negative margin of stability (i.e., an unstable body configuration) during recovery for perturbed walking due to a diminished ability to increase their base of support effectively. However, no evidence was found for HMDs or HHDs affecting stability during unperturbed locomotion. In conclusion, additional cognitive resources required for dual-tasking, using either display, are suggested to result in delayed response execution for perturbed standing and walking, consequently diminishing participants' ability to use stability control mechanisms effectively and increasing the risk of falls.