Development of additional training elements for the prevention of tripping, slipping and falling accidents supported by the use of virtual reality using the example of companies of steel production and postal and parcel delivery (ENTRAPon)

Status:

completed 11/2024

Aims:

Slips, trips, and missteps (SRF) are a major cause of accidents in both professional and private environments. The objective of this research project was to expand an existing proactive VR-based training module (BGHW warehouse simulator) by integrating a virtual city environment. Additionally, a biomechanical (reactive) perturbation training system was developed as both a mechanical and a VR-based version. The development and evaluation of the training components at three measurement points were carried out with the support of companies in the steel production sector (HKM) and postal and parcel delivery (Deutsche Post/DHL).

Activities/Methods:

A total of 110 employees were randomly assigned to one of two intervention groups (mechanical vs. VR-based training, n = 40 per group) or a control group (n = 30). All groups participated in the VR-based training simulation (warehouse or city). The three groups were exposed to unpredictable, ground-level slips, trips, and missteps in random order while walking on a treadmill at two walking speeds (their preferred speed and a faster speed) before (Pre) and after (Post) the training, as well as six months later (Ret). Kinematic data from a body-worn inertial sensor-based motion tracking suit (Xsens Link Motion Tracker (MovellaTM)) were used to measure stability tolerance and dynamic stability components through a full-body segment model (23 segments). Additionally, various person- and environment-related data were collected.

Results:

Both the VR and MECH groups showed a significant increase in stability tolerance in the steps following the perturbation (Post Pert) for the transfer movement of tripping at both walking speeds. Both intervention groups demonstrated an increase in the base of support (BoS) for fast walking speeds and a reduction in the speed of the center of mass (CoM, MECH group) or a reduction in the upper body flexion angle (VR group) within the first step after tripping "post-intervention" compared to "pre-intervention" at both walking speeds. Subjective fall monitoring also showed a reduction in SRF events after training. The work environment revealed positive factors for the transfer of learning into practice. The control group did not show any significant increase in stability tolerance between Pre and Post for any of the three gait perturbations, regardless of walking speed. Regarding the retention of adaptations in the transfer movement of tripping six months later (Ret), there were no significant differences in the components of dynamic stability compared to before the training. The study results demonstrate that both VR- and mechanically-based perturbation training improve walking stability and that the learned stability control mechanisms can be transferred to simulated ground-level tripping events.

Overall, the training was perceived by employees as valuable and useful. The two perturbation training methods were rated positively by participants both immediately after training and six months later. Only a few cases of cybersickness symptoms were reported during the VR-based perturbation training.

Outlook: To effectively achieve a significant reduction in trip-related accidents in the workplace through physical interventions, it is recommended to tailor the training dosage to individual needs and to assess fall risk in both professional and everyday contexts using data-driven technologies. Together with the VR-SRF training simulation, the training package demonstrates significant potential to reduce the likelihood of experiencing an SRF situation or a fall caused by tripping through the combined application of proactive and reactive elements.

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