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Peer-reviewedCC BYJournal of functional morphology and kinesiology

Gamified Augmented Sensorimotor Feedback During Balance Training Improves Postural Control and Nocturnal RMSSD.

5 affiliations
  1. 1Airway and UC Fit Digital Health-Exercise Physiology Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
  2. 2Baylor College of Medicine, Houston, TX 77030, USA.
  3. 3Chobanian and Avedisian School of Medicine, Boston University, Boston, MA 02118, USA.
  4. 4School of Medicine, Creighton University, Omaha, NE 68178, USA.
  5. 5The Fitness Prof, Los Angeles, CA 90001, USA.

Abstract

Background and Objectives: Augmented sensorimotor feedback may enhance motor learning during balance training, but whether these adaptations extend to cardiac autonomic regulation remains unclear. This study compared wobble-board training with gamified augmented feedback versus conventional wobble-board training on dynamic balance and nocturnal heart rate variability. Methods: Thirty adults were assigned to training with gamified-augmented feedback (GBT), conventional training (CBT), or control (CON). GBT and CBT completed three ~20-min sessions weekly for six weeks. Dynamic balance, measured via the modified Star Excursion Balance Test (mSEBT), and nocturnal Root Mean Square of Successive Differences (RMSSD) were assessed. Results: Group × time interactions occurred for RMSSD and mSEBT (both p < 0.001). RMSSD increased 6.93 ± 1.86 ms in GBT, versus 1.01 ± 1.38 and 0.80 ± 1.61 ms in CBT and CON, respectively. GBT exceeded CBT (mean difference, 5.92 ms; 95% CI, 4.37-7.46; Hedges' g = 3.46) and CON (6.12 ms; 95% CI, 4.49-7.76; g = 3.38; both adjusted p < 0.001); CBT did not differ from CON (p = 0.761). mSEBT increased 7.54 ± 1.62 points in GBT, 3.65 ± 1.50 in CBT, and 0.47 ± 1.46 in CON. GBT exceeded CBT (mean difference, 3.89 points; 95% CI, 2.42-5.36; g = 2.39) and CON (7.07; 95% CI, 5.63-8.52; g = 4.40), while CBT exceeded CON (3.18; 95% CI, 1.79-4.57; g = 2.06; all adjusted p < 0.001). Conclusions: Gamified augmented feedback and its associated features were associated with greater improvements in dynamic balance and RMSSD than conventional training. Mechanisms underlying RMSSD response require further investigation.

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BibTeX
@article{shatagopam2026gamified,
  title = {{Gamified Augmented Sensorimotor Feedback During Balance Training Improves Postural Control and Nocturnal RMSSD.}},
  author = {Vishruth Shatagopam and Jake Pirnazar and Phillip Goldman and Trent Yamamoto and Joshua A Kidwell and Brett A Dolezal},
  journal = {Journal of functional morphology and kinesiology},
  year = {2026},
  month = oct,
  doi = {10.3390/jfmk11040414},
  url = {https://europepmc.org/article/MED/42924693},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Gamified Augmented Sensorimotor Feedback During Balance Training Improves Postural Control and Nocturnal RMSSD.
AU  - Vishruth Shatagopam
AU  - Jake Pirnazar
AU  - Phillip Goldman
AU  - Trent Yamamoto
AU  - Joshua A Kidwell
AU  - Brett A Dolezal
PY  - 2026
DA  - 2026/10/10
JO  - Journal of functional morphology and kinesiology
DO  - 10.3390/jfmk11040414
UR  - https://europepmc.org/article/MED/42924693
AB  - Background and Objectives: Augmented sensorimotor feedback may enhance motor learning during balance training, but whether these adaptations extend to cardiac autonomic regulation remains unclear. This study compared wobble-board training with gamified augmented feedback versus conventional wobble-board training on dynamic balance and nocturnal heart rate variability. Methods: Thirty adults were assigned to training with gamified-augmented feedback (GBT), conventional training (CBT), or control (CON). GBT and CBT completed three ~20-min sessions weekly for six weeks. Dynamic balance, measured via the modified Star Excursion Balance Test (mSEBT), and nocturnal Root Mean Square of Successive Differences (RMSSD) were assessed. Results: Group × time interactions occurred for RMSSD and mSEBT (both p < 0.001). RMSSD increased 6.93 ± 1.86 ms in GBT, versus 1.01 ± 1.38 and 0.80 ± 1.61 ms in CBT and CON, respectively. GBT exceeded CBT (mean difference, 5.92 ms; 95% CI, 4.37-7.46; Hedges' g = 3.46) and CON (6.12 ms; 95% CI, 4.49-7.76; g = 3.38; both adjusted p < 0.001); CBT did not differ from CON (p = 0.761). mSEBT increased 7.54 ± 1.62 points in GBT, 3.65 ± 1.50 in CBT, and 0.47 ± 1.46 in CON. GBT exceeded CBT (mean difference, 3.89 points; 95% CI, 2.42-5.36; g = 2.39) and CON (7.07; 95% CI, 5.63-8.52; g = 4.40), while CBT exceeded CON (3.18; 95% CI, 1.79-4.57; g = 2.06; all adjusted p < 0.001). Conclusions: Gamified augmented feedback and its associated features were associated with greater improvements in dynamic balance and RMSSD than conventional training. Mechanisms underlying RMSSD response require further investigation.
SN  - 2411-5142
ER  -