Walking it off: habituation of gait at virtual high elevation

Introduction Fear and anxiety about falling can disrupt gait control, leading to activity restriction and increased fall risk in older adults. VR can be used to induce postural threat (e.g., by simulating high elevation settings) within a controlled environment, inducing fall‐related anxiety and cautious gait (i.e., slower, shorter steps) in young and older adults. However, it is unknown how emotional and motor responses to VR postural threat habituate across time because existing studies feature short exposures (10s or less). Before VR‐induced postural threat can be translated into an intervention, it is critical to understand threat-related gait habituation across time. Therefore, we investigated compensatory changes to gait within a 1‐min exposure to VR‐induced fall‐related anxiety. Methods Eighteen able-bodied young adults (mean age = 24.5 ± 6.4 years standard deviation) walked at self‐selected speeds in low VR elevations (ground level) and high VR elevations (∼15‐m elevation) along a wooden walkway (0.4 x 5.2 m) for 1 minute. Spatiotemporal metrics for the first (T1) and last six straight steps (T2) of each condition were calculated from 3D foot position. Results and Discussion Results revealed significant interactions between Height and Time for step length (p < 0.001), gait speed (p < 0.001), single support time (p < 0.001), and double support time (p < 0.001). This reveals changes within a single trial at high elevation that suggest gait became less cautious over time with exposure to postural threat in young adults. Habituation of gait with exposure to postural threat conditions shows the potential use of VR as an intervention to reduce the effects of fall‐related anxiety on gait.