The margin of stability is affected differently when walking under quasi-random treadmill perturbations with or without full visual support

Background. Sensory -motor perturbations have been widely used to assess astronauts' balance in standing during pre -/post- spaceflight. However, balance control during walking, where most falls occur, was less studied in these astronauts. A study found that applying either visual or platform oscillations reduced the margin of stability (MOS) in the anterior -posterior direction (MOSap) but increased MOS in the medial -lateral direction (MOSml) as a tradeoff. This tradeoff induced an asymmetric gait. This study extended the current knowledge to investigate overall stability under unpredictable environments. This study aimed to determine (1) whether quasi -random treadmill perturbations with or without full vision support would result in a significant reduction in MOSap but an increase in MOSml and (2) regardless of whether vision support was provided, quasi -random treadmill perturbations might result in asymmetric gait patterns. Methods. Twenty healthy young adults participated in this study. Three experimental conditions were semi -randomly assigned to these participants as follows: (1) the control condition (Norm), walking normally with their preferred walking speed on the treadmill; (2) the treadmill perturbations with full vision condition (Slip), walking on the quasi -random varying -treadmill -belt -speeds with full vision support; and (3) the treadmill perturbations without full vision condition (Slip_VisionBlocked, blackout vision through customized vision -blocked goggles), walking on the quasi -random varying -treadmill -belt -speeds without full vision support. The dependent variables were MOSap, MOSml, and respective symmetric indices. A one-way repeated ANOVA measure or Friedman Test was applied to investigate the differences among the conditions mentioned above. Results. There was an increase in MOSap in Slip (p = 0.001) but a decrease in MOSap in Slip_VisionBlocked (p = 0.001) compared to Norm condition. The MOSml was significantly greater in both Slip and Slip_VisionBlocked conditions compared to the Norm condition (p = 0.011; p < 0.001). An analysis of Wilcoxon signed -rank tests revealed that the symmetric index of MOSml in Slip_VisionBlocked (p = 0.002) was greater than in the Norm condition. Conclusion. The novelty of this study was to investigate the effect of vision on the overall stability of walking under quasi -random treadmill perturbations. The results revealed that overall stability and symmetry were controlled differently with/without full visual support. In light of these findings, it is imperative to take visual support into consideration while developing a sensory -motor training protocol. Asymmetric gait also required extra attention while walking on the quasi -random treadmill perturbations without full vision support to maintain overall stability.