Background: Current methods of postural control assessments and interventions to improve postural stability and thereby prevent falls often fail to incorporate the hazardous perturbation situations that frequently accompany falls. Virtual environments can safely incorporate these hazards. The purpose of the study was to identify if virtual slip and trip perturbations can be used as an exposure paradigm in place of real slip and trip perturbations to improve postural control. Methods: Fifteen healthy young adults were included in this study. Two paradigms, real gait exposure (real) and virtual environment gait exposure (virtual), consisting of real and virtual slip and trip trials, were performed by each participant in a counterbalanced order to avoid order effects. At baseline and following real and virtual paradigms, the modified clinical test for sensory integration and balance (mCTSIB), limits of stability (LOS), and single-leg stance (SLS) using BTracks balance plate were administered. Separate one-way (baseline vs. Real vs. Virtual) repeated measures analysis of variance were conducted on response variables. Results: In the posterior left quadrant of the LOS, significant differences were found after the real paradigm compared to baseline (
p = 0.04). For the anterior left quadrant and total LOS, significant differences post real paradigm (
p = 0.002 and
p < 0.001) and virtual paradigm (
p = 0.007 and
p < 0.001) compared to baseline were observed. For the SLS, the left-leg significant differences were observed post real paradigm (
p = 0.019) and virtual paradigm (
p = 0.009) compared to BL in path length, while significant main effects were found for mean sway velocity for the left leg only (
p = 0.004). For the right leg, significant differences were only observed after the virtual paradigm (
p = 0.01) compared to BL. Conclusions: Both virtual and real paradigms were identified to improve postural control. The virtual paradigm led to increased postural control in the right-leg SLS condition, while the real paradigm did not, without any adverse effects. Findings suggest virtual reality perturbation exposure acutely improves postural control ability compared to baseline among healthy young adults.
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