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Virtual Reality Balance Training for Overweight Intervention

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DISCUSSION:-

The purpose of the study was to determine if virtual reality balance training or traditional balance training can enhance balance in over weight individual.

The result of the present study showed that all the three group i.e. Control Group, Virtual reality group demonstrated a similar performance in both the measured variable and Traditional balance group give rise to more measurable improvement.

In this study positive relation found in the performance on the SEBT results. The usefulness of normalizing excursion distance data was illustrated by the existence of significant difference in excursion distance between genders on raw excursion distance scores; however a lack of gender difference was found following normalization of excursion distance to leg length. When using the SEBT as assessment tool, consideration for normalization should include leg length .This comprise either matching paired participations for leg length or normalizing excursion data to leg length.

Finding of the present study showed that effect on balance after six week in Control Group, Virtual Reality Group, no significant difference and Traditional balance Group significant difference. These results are not more effective in case of overweight individual in virtual balance training but effective in case of traditional balance training group. The lack of statistically significant differences in balance in virtual reality sample group because due to learning effect of the game in the subjects.

In the present study, the post intervention SEBT Composite scores in Traditional group showed a statistically highly Significant differences (p=.001) with the highest mean value observed and SLSTEOP also showed highly significant differences (p=.001) in all the three groups. SLSTECL showed highly significant differences in Control and traditional balance group and non significant in virtual balance group.

The probable reasons of dynamic balance increase due to tradition balance training as measured by SEBT are; The improvement in muscle strength of subject, force on neuromuscular system, activating sensory receptor. As overweight boys have lower strength relative to mass.

Finding the group-wise comparison showed that there was a statistically significant differences in the post- intervention SEBT and SLST composite score between Control Group and traditional Group and virtual balance training, In SEBT the difference between control group and virtual reality balance training group not significant, This could be due to the reason that not significant muscular involvement in the training in the present study. And in the Traditional balance training having significant muscular involvement, In the SLSTEOP and SLSTECL also having same as in SEBT balance effect in all the Group. In the virtual reality balance training group balance not significant improving, This could be learning effect of the game level. The result of the present study showed that there was a significant difference between the traditional and virtual reality balance group. The reasons could be the proprioception and muscular adaptation and enhancement of neuromuscular factors in the traditional balance group.

The result of within group analysis of the variable of the control group in this study showed a statistically no significant difference between pre and post intervention value of SEBT, SLSTEOP and SLSTECL composite score. The reason behind this could be no specific training which subjects in this group followed.

Findings of this research showed that virtual reality group showed a almost constant SEBT composite score after six week. And some decrease in SLSTEOP and SLSTECL composite score, The seems following reasons of the decrease learning effect of the game or some change in weight of the subject in this group followed.

This study showed that there is a statistically highly significant difference between the pre-intervention and post intervention score of SEBT, SLSTEOP and SLSTECL in traditional balance training group (p=0.001). The improvement in variable indicates that adaptation relating to increase in leg strength and proprioception and muscular coordination and muscular control.

In this research to critically examine the effectiveness of video game based balance training programs. Previous research studies have shown that balance programs have proven effective in improving balance measurements in a multiplicity of condition9, 16.

This study prove the results of those previous studies, but instead provides positive evidence of efficacy for the clinician who use to the video game based activities in their balance training programs. In this study, traditional balance program participation considerably improved in the Star Excursion Balance test activities from pre to post testing. The improvements were noted in activities that were also used as a training duration of exercise should be 4-week of period. It is a diverse possibility that a training effect occurred from these activities. However, despite their effectiveness, traditional balance programs often elicit patient observance difficulties. It is also significant to note that in this study the traditional balance program had the less engagement and enjoyment. 16.

Task chosen which was similar to everyday life activities were selected. Rising from a seated to a standing position is one of the most common activities of daily living. If children are less capable of lifting the body from sitting to standing because of excess fat mass, they might choose not to stand as often. During a sit to stand test, substantial leg strength and an adequate range of joint motion are required, posing a considerable challenge to balance 36,40.

Earlier study in obese young children demonstrated that decreased lower limb functionality impeded their ability to rise from a chair5. More BMI children spent significantly more time during all transfer phases of the rising task compared with the non-obese children, and most obese subjects moved their trunk backward before initiating the characteristic forward and upward motion to stand. Our findings are in agreement with these findings. Overweight boys showed slower weight transfer and a lower rising index (expressed in % body weight) during the sit to stand test on the pressure plate compared with normal-weight counterparts. This internal force production in raising the body to a standing position may be due to insufficient leg strength to lift the excess body weight. Overweight boys also had greater sway velocity in standing position, indicating that they have difficulties decelerating the forward trunk motion following the rise. it could be also a result from lower strength relative to mass. Overweight boys were also slower when performing a multiple sit-to-stand field test. As the multiple sit-to stand test is often used as an indicator of leg speed and power 4, This poorer performance in the multiple sit-to-stand test in overweight boys is in agreement with their lower rising index on the force plate.

The lower limb involved maximum reached distance in one limb while contralateral limb maintain balance in SEBT. The leg length having good significant correlation with excursion distance, as a longer limb would give a participant an advantage in reaching that limb further. The height and excursion distance would also correlate significantly. Because height and leg length strongly correlate with each other.

They were not especially strong in all the direction in The relations for height and leg length to excursion distance significant. The three anterior directions (anterior, anterolateral, anteromedial), with an r2 value of just the more correlations occurred between leg length and excursion distance in SEBT. This indicates that while leg length is a significant predictor of performance on the SEBT.24

The goal is to minimize displacement of the centre of pressure, a derivative of the vertical ground reaction force for the control in a static posture. The goal is to maximize reach distance while maintaining unilateral support in the measure of dynamic postural control. The amount of ground contact related to foot type defines the centre of pressure in excursion distance. Postural sway changes of the centre of pressure will produce to maximize excursion distance but is not quantified in the SEBT. Foot type is not having significant affect on the performance of the SEBT; some other reaching strategies and compensatory motions or both, that allow a subject to overcome a deficit potentially due to foot type.24

Clinical Relevance

The study signifies the use of traditional balance training in six week to enhance the static and dynamic balance in over weight individuals and reduce the chance of injury in activity of daily living.

With the help of this training normal population individual maintain health and fitness,which can reduce the chance of injury maintain and improve quality of life in daily activity.

Limitation of the study

The study includes middle age group and physically fit overweight individual.

Age group is variable (18-36) so that according to the several musculoskeletal and physiological changes occurring which can lead to balance problem.

Duration of the study six week, Because in this duration the food habit is not maintain so that BMI can be changes so balance can be hampered.

Sample including in the study was population mostly 20-30 years, so the result cannot be generalised to middle age population group .

Future Research

This study can be done on obese individual as only overweight individual were used in the present study.

This study can be use biomechanical correction and increased the muscular co ordination.

This study can help in athletic population by increase the duration of protocol according to the sports specific.

Conclusion

The finding of the present study may conclude that traditional balance training group having much more effective for the overweight individual, There is no much effect of virtual reality training program in case of overweight population, it is more effective in neurological abnormality subject as previous study said. And we are increase the duration of training, then its effect on balance is much more effective.


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