Interpersonal interactions for haptic guidance during balance exercises

Saskia M. Steinl, Patrick J. Sparto, Christopher G. Atkeson, Mark S. Redfern, Leif Johannsen

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
12 Downloads (Pure)


Background: Caregiver–patient interaction relies on interpersonal coordination during support provided by a therapist to a patient with impaired control of body balance.

Research question: The purpose of this study was to investigate in a therapeutic context active and passive participant involvement during interpersonal support in balancing tasks of increasing sensorimotor difficulty.

Methods: Ten older adults stood in semi-tandem stance and received support from a physical therapist (PT) in two support conditions: 1) physical support provided by the PT to the participant’s back via an instrumented handle affixed to a harness worn by the participant (“passive” interpersonal touch; IPT) or 2) support by PT and participant jointly holding a handle instrumented with a force-torque transducer while facing each other (“active” IPT). The postural stability of both support conditions was measured using the root-mean-square (RMS) of the Centre-of-Pressure velocity (RMS dCOP) in the antero-posterior (AP) and medio-lateral (ML) directions. Interpersonal postural coordination (IPC) was characterized in terms of cross-correlations between both individuals’ sway fluctuations as well as the measured interaction forces.

Results: Active involvement of the participant decreased the participant’s postural variability to a greater extent, especially under challenging stance conditions, than receiving support passively. In the passive support condition, however, stronger in-phase IPC between both partners was observed in the antero-posterior direction, possibly caused by a more critical (visual or tactile) observation of participants’ body sway dynamics by the therapist. In-phase cross-correlation time lags indicated that the therapist tended to respond to participants’ body sway fluctuations in a reactive follower mode, which could indicate visual dominance affecting the therapist during the provision of haptic support.

Significance: Our paradigm implies that in balance rehabilitation more partnership-based methods promote greater postural steadiness. The implications of this finding with regard to motor learning and rehabilitation need to be investigated.
Original languageEnglish
Pages (from-to)129-136
Number of pages8
JournalGait & Posture
Early online date20 Jul 2018
Publication statusPublished - Sep 2018


  • Interpersonal coordination
  • balance rehabilitation
  • social postural coordination
  • haptic support

Cite this