The Effects of Coding Schemes on Vibrotactile Biofeedback for Dynamic Balance Training in Parkinson’s Disease and Healthy Elderly Individuals

Coding scheme for earlier versions of vibrotactile biofeedback systems for balance-related applications was primarily binary in nature, either on or off at a given threshold (range of postural tilt), making it unable to convey information about error magnitude. The purpose of this paper was to explore the effects of two coding schemes (binary versus continuous) for vibrotactile biofeedback during dynamic weight-shifting exercises that are common physical therapists' recommended balance exercises used in clinical settings. Nine individuals with idiopathic Parkinson's disease and nine healthy elderly individuals participated in this paper. All participants performed dynamic weight-shifting exercises assisted with either the binary or continuous vibrotactile biofeedback delivered using with vibrating actuators (tactors) in either the anterior-posterior or medial-lateral direction. Participants' limits of stability at pre and post exercises were compared to evaluate the effects of the exercises on their range of motion. The continuous coding scheme produced significantly better performance than the binary scheme when both groups were performing dynamic weight-shifting balance exercises with assistive vibrotactile biofeedback. The results have implications in terms of maximizing the effects of error-driven motor learning and increasing performance on balance rehabilitation training combined with vibrotactile biofeedback.