Impact of Virtual Reality–Generated Construction Environments at Different Heights on Postural Stability and Fall Risk

Abstract

Background Falls due to postural instability are common in construction environments especially from a height. The purpose of the study was to investigate the impact of virtual reality (VR)-generated environments at different virtual heights on postural stability. Methods Nineteen adults were analyzed for postural stability, tested in real (No VR) environment and in three VR environments, randomly assigned, at virtual heights of 0 ft. (VR0), 40 ft. (VR40), and 120 ft. (VR120). Postural stability was quantified using center of pressure postural sway variables and analyzed using a repeated measures analysis of variance (ANOVA). Participants also completed a simulation sickness questionnaire (SSQ) before and after VR exposure and a presence questionnaire (PQ) after VR exposure. Findings Significant postural instability ( p < .05) was identified between VR and No VR, in which increased postural instability was evident in all VR conditions compared with No VR. Scores from SSQ were within a pre–post score difference of five and the PQ score was (104.21 ± 14.03). Conclusion/Application to Practice Findings suggest that VR environments, regardless of virtual height, induced increased postural instability, which can be attributed to visual sensory conflicts to the postural control system created by VR exposure. Participants’ subjective responses on SSQ and PQ confirmed the feasibility of using VR to represent realistic immersions in virtual heights. However, objectively, VR could potentially lead to postural instability, stressing caution. VR can be a potential tool for providing virtual high-altitude environment exposure for fall prevention training, however, more research is needed on postural adaptation with acute and chronic exposure to VR.

The Effects of Virtual Height Exposure on Postural Control and Psychophysiological Stress Are Moderated by Individual Height Intolerance

“…Thus, the increased body sway velocity in high fear participants suggests that they may not be able to use sensory feedback adequately when exposed to heights. We also observed that the magnitude of body sway decreased with ascending virtual height (similarly in both groups), which is in line with some of the previous reports ( Cleworth et al, 2012 ; Raffegeau et al, 2020 ), but not others ( Simeonov et al, 2005 ; Wuehr et al, 2019 ; Chander et al, 2021 ). The reasons for such inconsistent findings across the studies are not clear.…”

“…Second, also inconsistent are the reports on the effect of virtual height exposure on postural balance. While Cleworth et al (2012) found that body sway magnitude decreased during exposure to height in VR, several other studies reported the opposite effect, i.e., an increase in the magnitude of body sway (Wuehr et al, 2019;Raffegeau et al, 2020;Chander et al, 2021). Furthermore, it has been reported that postural reactions to simulated height are independent of individual height intolerance and the elicited fear (Wuehr et al, 2019), in contrast to real height exposure when postural adjustments were related to individual fear and anxiety levels (Davis et al, 2009).…”

The Effects of Visual Backgrounds in the Virtual Environments on the Postural Stability of Standing

“…The increased postural demands in the tandem and one-leg standing tasks increased the sway parameters in both VEs, but only a slight difference was observed between being in a photorealistic and a blank scene. The richness and fidelity help to increase level of presence in VR [14,19], but it may not be the most important contributing factor for postural stabilization according to our observation in a BS condition. The role of visual targeting in the VE was not highlighted in past studies and might have contributed to the effects of scene design.…”

“…Dynamic visual stimuli can be created by VR as a perturbation, which significantly influences postural control. For example, an increased center of pressure (COP) displacement or body sway is observed in response to perturbed visual scenes in VR, including moving dots, moving walls, rotating optokinetic drums or simulated movies [17][18][19][20]. However, these visual perturbations have increased risks of cybersickness or falls [17], and are therefore mostly used in postural assessment, but not in VR-based balance training.…”

Using immersive video technology for construction management content delivery: a pilot study

“…An analysis of the student's evaluation of this technology showed the use of VR positively impacted the students learning and understanding of the construction process. VR has also been utilized for various other safety-related applications, such as actively monitoring the site and informing laborers about the site's likely dangers (Cheng and Teizer, 2013), transferring the safety information to laborers (Guo et al, 2012), and height safety training (Chander et al, 2019(Chander et al, , 2021. More recently, Zhoa and Lucas (2015) developed a VR platform to educate workers on electrical power hazards.…”