The Relationship Between Psychological Factors and Postural Performance under Different Biofeedback Conditions

The postural biofeedback technique has been of potential interest to postural rehabilitation, as it promotes conscious postural control and reduces sway, ensuring body stability. However, it remains unclear whether the enhanced awareness of postural performance with biofeedback influences psychological states. Existing research suggests that psychological states such as confidence and anxiety regarding postural and fall risk may impact postural control. This study investigated the effects of two postural biofeedback techniques on balance confidence and anxiety, as well as the association between posturographic parameters and confidence and anxiety, respectively. Twenty-six participants were tested in three 60s tasks on a force platform: (1) eyes open (EO); (2) posturographic biofeedback (BF-COP), requiring participants to keep the centre of pressure (COP) close to a visual target; (3) laser biofeedback (BF-Laser), involving pointing a handheld laser at the same target with right wrist movements. The following COP parameters were computed: sway area, standard deviation, mean velocity and mean frequency in the antero-posterior (AP) and medio-lateral (ML) directions. Balance confidence and anxiety were assessed after each task using visual analog scales (0–100). ANOVA revealed lower balance confidence in the BF-COP task (mean ± SD; 73 ± 22%) compared to EO (86 ± 22%). For the anxiety scale, no significant differences were found between EO (21 ± 33%), BF-COP (28 ± 25%) and BF-Laser (24 ± 30%). For the BF-COP task, sway area, ML standard deviation, and ML mean velocity showed a negative moderate correlation with balance confidence, with greater body sway corresponding to lower confidence. Current findings suggest that psychological factors may be associated with postural stability changes during the postural biofeedback.