Using Virtual Reality (VR) to Reduce Mobility-Related Anxiety in Lower-Limb Prosthesis Users (LLPU)

The purpose of this project is to determine the utility of virtual reality (VR)-based exposure therapy to reduce mobility-related anxiety lower limb prosthesis users (LLPU). LLPU experience more falls and greater fear of falling compared to the community-dwelling population without amputation, with most LLPU reported having fallen at least once in the past year. Reducing the risk of falling may increase physical activity levels and reduce medical costs and incidence of death in LLPU. Leveraging evidence-based interventions that use VR to administer exposure therapy treatment in combination with laboratory-based methods of inducing a postural threat that elicits mobility-related anxiety offers an untapped mechanism to improve balance confidence in LLPU. In this project, LLPU and controls without prostheses (young and older adults) are exposed to high elevation VR settings across time and undergo repeated exposures to mobility-related anxiety in these settings. In Aim 1, researchers focus on how controls respond across time and with repeated exposure, and in Aim 2, determine how LLPU respond to mobility-related anxiety across time and with repeated exposure in anxiety-inducing VR settings, and their responses compared to controls. Results from this study may show how LLPU adapt differently to mobility-related anxiety induced with a high elevation VR setting compared to healthy controls across time and repeated exposures. When complete, this project identifies targets for intervention and individualized rehabilitation in LLPU and shows whether adopting VR-based exposure approaches in rehabilitation methods may reduce fall risk and increase activity levels, which will consequently improve balance confidence and community ambulation in LLPU.