State and Trait Anxiety Alter Postural Control in Healthy Adults

Background: Both anxiety and visual motion sensitivity are known to influence sensory integration and balance control. The State Trait Anxiety Inventory includes subscales that assess distinct aspects of anxiety, which may be worthwhile to measure given they are mapped differently in the brain and may have different functional implications. Purpose: This study aimed to clarify the role state and trait anxiety may play in postural control when measured in degraded sensory environments. Specifically, we studied the degree to which state anxiety may influence the effect of visual and somatosensory manipulations on postural control in a healthy adult cohort. Research Design: This is a prospective repeated-measures design. Study Sample: Twenty-six healthy adults denying the presence of hearing or balance deficits. Data Collection and Analysis: Postural control was measured on variable support surfaces and in dynamic and static virtual visual environments. Trait anxiety was measured prior to testing, and state anxiety was measured during postural control testing using the State Trait Anxiety Inventory. Trait anxiety score was used as a between-subjects factor and state anxiety score was used as a covariate. Results: There was a significant main effect of visual condition and a significant interaction between visual condition and support surface. The effect of the visual manipulations varied based on support surface after adjusting for state anxiety level. Conclusions: The influence of visual manipulation on postural control varied with the support surface type and the degree of state anxiety. The data imply that individuals with higher state anxiety may adopt strategies for postural control that are different from those of others with minimal anxiety overlay. Further, the effects of anxiety on postural control may vary based on sensory context, as well as individual traits unassociated with context. In healthy adults anxiety might not only amplify symptoms but also alter how sensory information is processed and interpreted. Clinical Relevance Statement: This study demonstrates that varying degrees of state anxiety may affect postural control differently in degraded sensory environments. The findings suggest that integrating anxiety metrics into vestibular evaluations may provide insight into the functional outcomes related to visual motion sensitivity.