Walk This Beam: Impact of Different Balance Assistance Strategies and Height Exposure on Performance and Physiological Arousal in VR

Dynamic balance is an essential skill for the human upright gait; therefore, regular balance training can improve postural control and reduce the risk of injury. Even slight variations in walking conditions like height or ground conditions can significantly impact walking performance. Virtual reality is used as a helpful tool to simulate such challenging situations. However, there is no agreement on design strategies for balance training in virtual reality under stressful environmental conditions such as height exposure. We investigate how two different training strategies, imitation learning, and gamified learning, can help dynamic balance control performance across different stress conditions. Moreover, we evaluate the stress response as indexed by peripheral physiological measures of stress, perceived workload, and user experience. Both approaches were tested against a baseline of no instructions and against each other. Thereby, we show that a learning-by-imitation approach immediately helps dynamic balance control, decreases stress, improves attention focus, and diminishes perceived workload. A gamified approach can lead to users being overwhelmed by the additional task. Finally, we discuss how our approaches could be adapted for balance training and applied to injury rehabilitation and prevention.