Exploring the challenges of avoiding collisions with virtual pedestrians using a dual-task paradigm in individuals with chronic moderate to severe traumatic brain injury.
Thiago de Aquino Costa Sousa, Isabelle J Gagnon, Karen Z H Li and 2 others
PMID 38755606WHAT IT FOUND
People with chronic traumatic brain injury walked closer to virtual pedestrians and started avoiding them later when doing a cognitive task.
They did not hit the obstacles, but their strategy was riskier than healthy adults, who widened their path and slowed down.
Key findings
01Under dual-task conditions, participants with moderate-to-severe TBI initiated trajectory deviations later and at a closer distance to the virtual pedestrian compared to single-task walking, while healthy controls initiated deviations earlier and further away.
02Participants with moderate-to-severe TBI experienced a significant reduction in cognitive task accuracy when walking and performing a complex auditory task simultaneously, whereas healthy controls maintained high accuracy.
03Although collision rates were low and similar between groups (1.25% of trials), the TBI group showed smaller minimum distances and lateral deviations from the virtual pedestrian during dual-task walking, indicating a riskier avoidance strategy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a virtual reality environment, which may not perfectly replicate real-world walking dynamics, though previous research suggests differences are small. The sample size was small (12 per group), limiting the generalizability of the findings. The study was conducted during the COVID-19 pandemic, which may have influenced participants' social distancing behaviors and anxiety levels. The TBI participants were relatively high-functioning (able to walk at 0.7 m/s or greater without aids), so results may not apply to those with more severe mobility impairments.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not assume that a lack of collisions in a controlled setting means the patient is safe in complex community environments. The study found no difference in collision rates, but the TBI group adopted a riskier strategy (walking closer to obstacles) that could lead to collisions in busier or less predictable real-world settings.