The Effect of walking with eyes closed (Makarach) on postural control and the autonomic nervous system (ANS) function: A randomized controlled trial

Background: Postural control (PC) is essential for performing complex movements and often deteriorates over time due to various factors, necessitating more flexible exercise options. Mind-body practices are purported to improve postural control. Objective: To determine the effect of Makarach, a mind-body practice, on postural control and the autonomic nervous system (ANS) function. Materials and methods: A randomized controlled trial (RCT) was conducted involving 76 participants, divided into two groups: experimental group (EG, N=38) and control group (CG, N=38). The EG walked forward and backward on two yoga mats with eyes closed while the CG performed tandem walking (TW). Both groups underwent a four-week training program (15 minutes per day, three days per week). The Y Balance Test (YBT) assessed the dynamic postural control (PC) in the anterior (A), posterolateral (PL), and posteromedial (PM) directions. The composite score (CS) was used for overall performance in the YBT. The Balance Error Scoring System (BESS) assessed static PC on firm (FIS) and foam (FOS) surfaces. Heart Rate Variability (HRV) components, including low frequency (LF), high frequency (HF), and low to high frequency (LF/HF) ratio, were used to evaluate the ANS function. All outcomes were measured before and after training. Data analyses were performed using intention-to-treat analysis. Results: The dynamic and static PC was found to increase in EG only. Significant differences were found in A, PL, PM, and overall dynamic PC (CS) in dominant and non-dominant legs (p<0.05) and (p<0.05), respectively. Significant differences were also found in static PC in FIS (p<0.05), while no significant difference was observed in FOS. There were no significant differences in any HRV components (p≥0.05). There was significant interaction between groups and time in dynamic PC and FIS, but no significant within-group difference in any CG variables. Conclusion: Walking with eyes closed (Makarach) was found to significantly increase dynamic and static PC among healthy individuals after four weeks of training in comparison to before training. Additionally, Makarach demonstrated greater effectiveness in improving PC than TW.