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Research report
a r t i c l e
i n f o
Article history:
Received 3 July 2011
Received in revised form 30 August 2011
Accepted 4 September 2011
Available online 12 September 2011
Keywords:
Path length estimation
Target-directed walking
Locomotor body schema
Gait
Distance perception
Environmental cues
a b s t r a c t
In a dark environment, when vision is excluded, humans are usually able to walk towards a target the
position of which was previously memorized. Changes in spatio-temporal gait parameters, the presence
of obstacles on the ground or pathway tilt can affect their performances. The aim of this study was
to investigate the inuence of the environment on this ability. We have enrolled sixty healthy subjects,
separately tested in a small indoor and in an outdoor open-eld environment. In experiment 1, signicant
differences were found between 15 indoor and 15 outdoor blindfolded walkers. According to previous
studies, the distances walked outdoors were not signicantly different from the three-tested targets
distances (3 m, 6 m and 10 m). Conversely, a systematic and signicant undershooting was observed for
blindfolded indoor walkers for all the three distances (errors: 0.34, 0.73 and 1.99 m, respectively).
This indoor undershooting was found related to shorter steps not compensated by any increment of the
step number. In experiment 2, also the perception of the indoor distance resulted underestimated in
other two tested groups of 15 subjects each. But the perceived distance resulted poorly correlated with
motor performances (R = 0.23, p = 0.410). In spite of the fact that the errors were consistent among trials,
when indoor walkers could not access to environmental acoustic features, their performance resulted
highly variable among subjects, but it improved, on average. At the light of these results, the environment
seems acting as a selective tuning between different strategies.
2011 Elsevier B.V. All rights reserved.
1. Introduction
Slowly, he opened the door and walked into the dark room. People are usually accurate in walking without vision to previously
seen targets, such as above described for Father Frollo, the famous
character of Victor Hugos The Hunchback of Notre Dame.
Many studies have investigated this ability that requires the
minimization of the distance between the body position, continuously updated during walking, and the memorized position of a
previously seen target. Vision improves body stability during standing and locomotion, and it drives gait cycle modulation, navigation,
and obstacle avoidance [13]. However, when there are no visual
information, other senses could be used, such as acoustic feedback,
tactile exploration or internally generated self-motion signals for
determining own current position and orientation [1,15]. Accurate
performances of target-directed blind walking were recorded for
distances out to 24 m under open eld conditions [21], even for
passive translations [9,15].
Abbreviations: WS, walking speed; WD, walked distance; RD, real distance; N
steps, number of steps; SL, step length; SF, step frequency; RMS, root mean square;
HR, harmonic ratio; AP, antero-posterior; LL, latero-lateral; CC, cranio-caudal.
Corresponding author. Tel.: +39 06 51501005; fax: +39 06 51501004.
E-mail address: m.iosa@hsantalucia.it (M. Iosa).
0166-4328/$ see front matter 2011 Elsevier B.V. All rights reserved.
doi:10.1016/j.bbr.2011.09.007
This shows that efferent, proprioceptive and vestibular information about locomotion could be closely calibrated to visually
perceived path, especially for athletes [3] and young subjects [14].
To explain the ability to estimate the distance walked while
blindfolded, it has been hypothesized the existence of an internal model, called locomotor body schema [7]. This should combine
the internalized knowledge of body segment lengths with the perceived exo-extensions of lower limb joints during the gait cycle,
allowing humans to estimate the length of their steps. In fact, the
step length is the result of a complex relationship between hip, knee
and ankle angular positions and thigh, shank and foot lengths. And
the walked distance is the result of the combination of the step
length and the number of performed steps.
However, this target-directed blind walking ability was found
altered if subjects were asked to walk out of self-selected conditions. When subjects were asked to walk at slower/faster speeds [3]
or with shorter/longer steps [15], they tended to over/undershoot
the target. On the other hand, faster self-selected speed after many
task repetitions were observed associated with overshooting [19],
while undershooting was observed in subjects walking on stilts [7].
From a perceptive point of view, our capacity to judge the
distance of a target from us can be affected by the surrounding environment [12]. For example, this distance appears greater when it
is near the end of a hallway than when farther from its end [20], or
when the pathway is ascending and hence requiring more effort to
125
During these trials, subjects were reassured that an experimenter can promptly
advise them if they were going to hit a wall in indoor conditions. However, none of
them needed his intervention.
To avoid some possible learning and/or cognitive effects, no verbal feedback was
given to the participants about their performances. In fact, subjects had been guided
back to the starting-line still blindfolded by the experimenter.
After the three blindfolded conditions, subjects were asked to stand on the
starting-line and, after an acoustic signal, to walk to the 10 m target line formed
by tape on the ground with their eyes opened. This test was performed in order to
measure the normally self-selected gait spatio-temporal parameters under visual
control.
2.4. Experiment 2: testing distance perception, acoustic inuence and
repeatability
In the rst task of experiment 2, participants were asked to judge the distance
between themselves and the target person located at 8 m from them, verbalizing
it. Before testing, at each participant was shown a 1 m ruler as aid for distance
judgement, similarly to the experiment performed by Stefanucci et al. [24].
In the second task, the blindfolded walkers wore headphones in which white
noise was played in order to eliminate environmental acoustic feedbacks [3,9]. In
this test, the target person was located at the distance of 10 m.
In the third task, we investigated the subjects precision, i.e. the repeatability of
their performances among three trials in which subjects could see the target person, located at 6 m from the starting-line, and they were asked to walk blindfolded
towards the target position (without headphones).
This second experiment was specically designed to further investigate: if the
distance perception was different in the two different environments; if the environmental acoustic clues could affect the subjects performances; if subjects were
more accurate in an indoor versus outdoor environment. It was performed by other
two groups of 15 subjects each, in the same two environments (above described)
and using the same measurement settings (below described) of the experiment 1.
To avoid learning effects, cross-effects and/or fatigue, only one distance was tested
for each task of experiment 2.
2.5. Measurement setting
Accelerometry, a suitable simple quantitative technique, was used to objectively
assess the dynamic gait stability of subjects during walking and to estimate spatiotemporal gait parameters [11]. During all the above tests, participants wore an
elastic belt containing a wireless triaxial accelerometer (FreeSense , Sensorize s.r.l.,
Rome; fsampling = 100 Hz) located on the back in correspondence of L2L3 spinous
processes, close to the subjects centre of mass, and providing acceleration signals
along the three body axis (antero-posterior, AP; latero-lateral, LL; cranio-caudal,
CC). The error between walked distance (WD) and real target distance (RD) was
measured by the experimenter using a 10 m graduated tape. Subjects, in fact, were
asked to maintain their achieved position after their decision to stop their walking
to allow the error measurement (error = WD RD). The time between rst and last
subjects movement (time) and the number of performed steps (N steps, equal to
the number of AP-acceleration negative peaks, as shown in Fig. 2 for a representative subject) were computed from 20 Hz-low-pass-ltered accelerometric signals.
Then, other spatio-temporal gait parameters were estimated: the mean step length
(SL = WD/N steps), the mean step frequency (SF = N steps/time), the mean walking
speed (WS = WD/time). The acceleration root mean square (RMS) was used to assess
the upper body dynamic stability. In fact, it is an indicator of average magnitude
of upper body accelerations, because it coincides with the standard deviation in
a signal with null mean [3,8]. The gait rhythmicity was evaluated by the computation of the harmonic ratio (HR). It is the ratio between even/odd harmonics on
AP and CC and between odd/even harmonics on LL over a stride (two steps). We
reported in the results the mean values of RMS and HR, computed along each body
axis and over three strides recorded in the middle of walking pathway [11]. Because
an increase of walking speed (WS) corresponds to an increase of RMS, independently on subject stability, a normalized RMS was also computed as follows [16]:
RMSn = RMS SL/WS2 = RMS SF/WS.
3. Results of experiment 1
3.1. Effects of environment on blindfolded walking
During blindfolded walking to a memorized target, a good
performance was recorded for outdoor walkers. Conversely,
indoor walkers signicantly undershot the target, as shown in
Fig. 3. This difference was statistically signicant, as shown in
Table 1.
The percentage of the performed errors in respect of the three
target distances was 11 10%, 12 13% and 20 10% for
indoor walkers and 2 19%, +2 17% and 2 16% for outdoor
126
Fig. 1. The two experimental environments: indoor (above) and outdoor (below). The two grounds were similar in dimensions (indoor: 18 m 4 m; outdoor: 18.4 m 4.4 m)
and paved by tiles similar in dimensions (indoor: 0.44 m 0.44 m; outdoor: 0.40 m 0.40 m), colours (light grey for both of them), and material.
The indoor environment is a long hall with two windows on the short sides, and doors on lateral long walls (kept closed during experiments). Distance between posterior
wall and starting line was 1.5 m, whereas the distance between the line of 10 m and frontal wall was 6.5 m.
The outdoor environment is a little paved place in the park of our hospital, encompassed by lawn. Its global dimensions are 18.4 m 8.4 m, however, a large strip (0.4 m)
formed by marble slab (different in colour from the surrounding tiles) divided it into a side large 3.6 m and another one, in which experiments were conducted, of 4.4 m.
Distance between posterior border and starting line was 2 m, and between the line of 10 m and anterior border was 6.4 m. The most close obstacles were trees, distant more
than 20 m further the line of 10 m along the walking line and more than 8 m on the left side of subjects.
A repeated measure ANOVA showed that errors were signicantly affected by the environment (between subject factor,
main means: 1.02 1.04 m indoor vs 0.03 1.11 m outdoor,
p < 0.001), by the distance (within subject factor: p = 0.001), and by
the interaction of these two factors (p = 0.003, as detailed in Table 1).
In fact, the undershooting was higher indoor and for longer distances, as shown in Fig. 3. When the errors were evaluated in terms
Fig. 2. Antero-posterior accelerometric signal for a male subject enrolled in the experiment 2 during the rst trial of 6 m test performed indoor. The methods to compute
gait spatio-temporal parameters from this signal and measured walked distance (WD) are reported for this exemplicative case.
Fig. 3. Mean and standard deviation of the error recorded for indoor (black circles)
and outdoor walkers (grey circles) during blindfolded walking of experiment 1. The
error was dened as the differences between walked distance (WD) and real distance
to walk (RD), in respect of the three tested distances. Circles are joined by a 2nd
order polynomial t. Stars indicated a p < 0.008 (=0.05/6 for Bonferronis correction
on six comparisons) obtained by one-sample two-tail t-tests performed to assess
the difference from an ideal error of 0.
127
gait parameters, upper body stability and gait rhythmicity. Conversely, when visual information was removed, signicantly lower
values of spatio-temporal parameters were observed in indoor
walkers.
The indoor walkers performed errors signicantly correlated
with their walking speed (R = 0.55, p = 0.034): slower was their gait,
shorter was the walked distance, undershooting the target. On the
other hand, the outdoor errors resulted signicantly correlated only
with the number of steps (R = 0.63, p = 0.013), and not with the other
parameters, such as the walking speed (R = 0.44, p = 0.104).
Lower upper body accelerations along the three body axes were
recorded for blindfolded indoor walkers, related to their reduced
WS, in respect of blindfolded outdoor walkers. In terms of gait
rhythmicity, it is noteworthy the signicant interaction of environment and vision on the HR in LL direction. During open eyes walking
it was higher for indoor than outdoor walkers (see Tables 2 and 3),
the opposite occurred in blindfolded condition, with all the three
HR values quite higher outdoors than indoors.
Neither the number of steps nor the time spent walking resulted
signicantly different between indoor and outdoor walkers (see
Table 2). For the distance of 10 m, indoor walkers performed a
number of steps not signicantly different in closed and open eyes
conditions (post hoc analysis: 15.7 1.4 vs 16.4 2.4, p = 0.215).
Conversely, participants took a longer amount of time to walk to
the target while blindfolded than when walking under visual control (post hoc analysis: 11.1 1.5 s vs 9.1 0.9 s, p < 0.001). For the
same distance, outdoor walkers implied more steps and more time
when blindfolded than when supported by vision (closed vs open
eyes: number of steps = 17.1 2.6 steps vs 15.1 1.6 steps with
open eyes, p = 0.020; time = 10.6 2.5 s vs 8.5 1.1 s, p = 0.007).
4. Discussion of experiment 1
Indoor and outdoor walkers did not show any differences when
walking for 10 m under visual control. Conversely, many differences were recorded when they were asked to walk blindfolded.
Outdoor walkers were, in mean, accurate into walking to a memorized target, in accordance with previous studies [3,5]. On the
contrary, indoor walkers systematically undershot the target. The
easiest explication of this behaviour could be the fear to hit one
of the indoor walls. Furthermore, we tested nave subjects without any experience of blindfolded walking in the two experimental
environments [3]. It has been shown that the given practice, sometimes at great length before testing, could imply learning or a
reduction of fear on the subjects during the recorded performance
[19].
The closeness of indoor lateral walls and the fear to hit one of
them could imply a shorter distance walked by our blindfolded
Table 1
Effects of environment and distance on subjects performances and gait spatio-temporal parameters.
Tests on 3 m, 6 m, 10 m
blindfolded
Environment
(indoor vs outdoor)
Distance
(3 m; 6 m; 10 m)
Interaction
Environment
Distance
Leuvenes test
p-value
3m
6m
10 m
Performance
Error [m]
Error [%]
Time
N steps
15.69
13.10
0.09
0.81
<0.001
0.002
0.769
0.376
10.07
2.15
192.77
331.59
0.001
0.126
<0.001
<0.001
6.44
1.17
0.82
0.46
0.003
0.318
0.445
0.636
0.026
0.026
0.144
0.116
0.460
0.460
0.554
0.190
0.120
0.120
0.427
0.999
Spatio-temporal
parameters
SF
SL
WS
3.19
10.52
12.54
0.085
0.003
0.001
2.41
253.34
181.51
0.100
<0.001
<0.001
1.33
1.87
3.68
0.274
0.164
0.031
0.071
0.427
0.216
0.692
0.526
0.420
0.258
0.530
0.088
Results of repeated measures ANOVA on indoor vs outdoor data (F[1,28] for environment, F[2,56] for distance and interaction between environment and distance) for the
distances of 3 m, 6 m and 10 m. The measured parameters were: error (reported in meters and percentage of the distance to walk), time spent walking to complete the task,
number of performed steps (N steps), step frequency (SF), step length (SL), walking speed (WS). The last three columns reported the p-values of the Levenes homogeneity
tests performed to compare the variances between indoor and outdoor walkers for each one of the three distances. In bold the p-values <0.05.
128
Fig. 4. Correlations between walked distance (WD) and (A) walking speed (WS, above) and (B) step length (SL, below) during blindfolded walking indoors (black markers)
and outdoors (grey markers) for the three possible distances: 3 m (squares), 6 m (empty circles) and 10 m (lled circles) in the experiment 1. Regression lines were showed
in gure for each one of the six conditions: indoors (black lines) and outdoors (grey lines) per 3 distances. The value of Pearsons correlation coefcient R was shown for each
correlation. The correlation was signicant (p < 0.05) if R > 0.51.
Table 2
Effects of environment and vision support on subjects performances, gait spatio-temporal parameters, and upper body accelerations.
Tests on 10 m
Environment
(indoor vs outdoor)
Vision
(eyes open vs
blindfolded)
Leuvenes test
p-value
Interaction
Environment
Vision
Eyes open
Eyes closed
Performance
Error
Time
N steps
14.05
1.22
0.01
0.001
0.279
0.957
19.98
29.25
8.44
<0.001
<0.001
0.007
14.05
0.01
2.00
0.001
0.975
0.168
0.362
0.904
0.120
0.427
0.999
Spatio-temporal
parameters
SF
SL
WS
1.97
6.50
11.23
0.171
0.017
0.002
106.34
104.20
107.86
<0.001
<0.001
<0.001
6.95
6.73
5.73
0.014
0.015
0.024
0.147
0.685
0.206
0.424
0.530
0.088
RMS
AP
LL
CC
6.70
2.02
4.21
0.015
0.167
0.050
97.43
28.38
89.64
<0.001
<0.001
<0.001
10.02
5.38
11.04
0.004
0.028
0.002
0.988
0.447
0.928
0.187
0.119
0.038
RMSn
AP
LL
CC
5.24
1.04
2.67
0.030
0.316
0.113
107.38
29.92
98.36
<0.001
<0.001
<0.001
8.00
5.69
15.42
0.009
0.024
0.001
0.747
0.677
0.964
0.065
0.116
0.050
Harmonic ratio
AP
LL
CC
0.29
0.68
0.01
0.592
0.416
0.950
8.03
0.58
1.95
0.008
0.454
0.173
0.617
6.16
1.72
0.439
0.019
0.201
0.096
0.029
0.071
0.755
0.590
0.467
Results of repeated measures ANOVA on indoors vs outdoors data (F[1,28] for environment, F[2,56], with eyes open vs closed and interaction between environment and
vision) for the distances of 10 m. The measured parameters were: error, time spent walking to complete the task, number of performed steps (N steps), step frequency
(SF), step length (SL), walking speed (WS), accelerations root mean square (RMS), normalized acceleration RMS (RMSn) and harmonic ratio along the three body axes (AP:
antero-posterior; LL: latero-lateral; CC: cranio-caudal). The last two columns reported the p-values of the Levenes homogeneity tests performed to compare the variances
between indoor and outdoor walkers for each one of the two vision conditions. In bold the p-values <0.05.
129
Table 3
Parameter values and post hoc analyses for the distance of 10 m with eyes open and closed condition.
Tests on 10 m
Outdoor
Blindfolded walking
p
Indoor
Outdoor
1.99 1.03
11.13 1.53
16.40 2.41
0.17 1.56
10.64 2.52
17.07 2.63
p
0.001
Performance
Error [m]
Time [s]
N steps
9.070.87
15.73 1.44
8.55 1.11
15.13 1.55
Spatio-temporal
parameters
SF [1/s]
SL [m]
WS [m/s]
1.74 0.12
0.64 0.06
1.11 0.11
1.78 0.13
0.67 0.07
1.19 0.17
0.383
0.262
0.157
1.48 0.12
0.49 0.07
0.73 0.11
1.63 0.21
0.58 0.08
0.95 0.18
0.005
0.004
<0.001
RMS
AP [m/s2 ]
LL [m/s2 ]
CC [m/s2 ]
1.71 0.35
1.57 0.40
2.82 0.67
1.86 0.41
1.55 0.43
2.79 0.75
0.283
0.943
0.895
1.14 0.21
1.10 0.24
1.49 0.38
1.53 0.39
1.38 0.45
2.21 0.67
0.002
0.046
0.001
RMSn
AP
LL
CC
0.89 0.17
0.81 0.15
1.45 0.25
0.88 0.15
0.75 0.22
0.33 0.31
0.960
0.394
0.227
1.06 0.23
1.03 0.20
1.37 0.20
1.01 0.23
0.92 0.29
1.45 0.35
0.452
0.209
0.452
Harmonic
ratio
AP
LL
CC
8.01 3.10
4.27 3.11
8.89 3.23
7.54 1.89
2.81 0.81
9.48 2.48
0.089
6.15 2.07
2.91 1.25
7.67 3.23
6.31 1.78
3.53 0.99
9.36 3.35
0.056
Mean and standard deviations of computed parameters for the distance of 10 m under shut and open eyes conditions for indoor and outdoor walkers in the experiment 1
and the p-value of post hoc analyses obtained by comparing the values recorded in the two environments. The measured parameters were: error, time spent to complete the
task walking, number of performed steps (N steps), step frequency (SF), step length (SL), walking speed (WS), acceleration root mean square (RMS), its corresponding values
normalized for WS (RMSn), and harmonic ratio (HR). These last three parameters were computed along the three body axes: antero-posterior (AP), latero-lateral (LL) and
cranio-caudal (CC). In bold the p-values <0.025 for Bonferronis correction.
130
Table 4
Repeatability of subjectsperformances and gait spatio-temporal parameters.
ICC(2,1)
Repeatability Tests on
6 m blindfolded
Indoor
Outdoor
Performance
Error
Time
N steps
0.731
0.728
0.776
0.720
0.379
0.619
Spatio-temporal
parameters
SF
SL
WS
0.472
0.703
0.756
0.727
0.691
0.609
6. Discussion of experiment 2
Two way random intra-class correlation coefcient assessed for the three trials of
6 m test in experiment 2 on main spatio-temporal gait parameters: error, time spent
to complete the task walking, number of performed steps (N steps), step frequency
(SF), step length (SL), walking speed (WS). In bold ICC(2,1) 0.7.
Table 5
Repeatability of subjects errors.
Environment
Experiment 1
Indoor
+
++
+++
12
2
1
0
9
2
2
2
21
4
3
2
Outdoor
+
++
+++
5
3
2
5
6
4
2
3
11
7
4
8
Experiment 2
Total
The number of subjects who performed one of the reported series of motor error
are tabled. This series was related to the motor errors performed during the three
distances of the experiment 1 and the three trials of 6 m test of the experiment 2.
Positive (+) and negative () signs correspond to over- and under-shooting, respectively. The series of signs in table do not correspond to the temporally sequence of
trials, but only to the number of occurrences.
outdoors), but also the step length (0.53 0.09 m vs 0.58 0.08 m)
and the walking speed (0.76 0.13 m/s vs 0.88 0.17 m/s). Conversely, the acoustic feedback directly affected the time spent
to complete the task (10.88 2.06 s with environmental acoustic
feedback vs 12.46 2.81 s with white noise), the step frequency
(1.56 0.19 steps/s vs 1.41 0.20 steps/s) and the harmonic ratio
along cranio-caudal axis (8.52 3.69 vs 6.50 2.51; F[1,56] = 6.16,
p = 0.016). Also the interaction between environment and acoustic
features resulted signicantly affecting error, step length and walking speed. It was due to the fact that, in absence of acoustic feedback,
only the performances of indoor walkers changed (post hoc analysis: p = 0.004), and not that of outdoor walkers (p = 0.817). In fact,
the underestimation observed in the experiment 1 (1.99 1.03 m)
was signicantly reduced in the subjects hearing white noise during
Table 6
Effects of environment and its acoustic cues on subjects performances and gait spatio-temporal parameters.
Tests on 10 m blindfolded
Environment
(indoor vs outdoor)
Acoustic features
(environmental vs
white noise)
Interaction
Environment
Acoustic features
Performance
Error
Time
N steps
5.22
0.33
0.14
0.026
0.569
0.908
3.79
5.99
0.55
0.057
0.018
0.463
5.23
0.04
0.14
0.026
0.851
0.511
Spatio-temporal
parameters
SF
SL
WS
2.36
4.81
9.27
0.130
0.032
0.004
9.36
2.49
1.28
0.003
0.120
0.263
2.85
4.14
8.08
0.097
0.047
0.006
Results of repeated measures ANOVA performed on all the 60 participants on the data recorded during the 10 m test performed blindfolded to investigate the main effects of
the environment (F[1,56], p), acoustic features (F[1,56], p) and their interaction (F[1,56], p). The measured parameters were: error, time spent walking to complete the task,
number of performed steps (N steps), step frequency (SF), step length (SL), walking speed (WS). In bold the p-values <0.05.
7. General discussion
7.1. Different performances in different environments
The aim of this study was to investigate if the surrounding environment could affect the capacity to walk towards a memorized
target without the visual support. The most striking result was
that although healthy subjects were accurate in an open outdoor
eld, as it could be expected [3,5,15], they undershot the target
in an indoor small environment. It was a surprising result because
the elimination of some environmental cues increased the performance variability among subjects, but, on the average, it improved
their performance.
In fact, in an indoor room, rich of informative cues related to spatial layout, such as doors and windows, subjects underestimated
the targetdistance and undershot it walking blindfolded. On the
contrary, in an outdoor environment, poor of informative cues,
their performances were, on the average, more accurate, even if
more variable among subjects (as shown by higher variances and
lower values of intra-class correlation coefcient). Analogously,
when indoor walkers could not access to environmental acoustic
cues, their performances became more accurate, but more variable
among subjects.
Gross errors were recorded in the judgement of a distance in
terms of conventionally used metrics (m). However, verbal and
motor performances were not signicantly correlated. And the
underestimation of the indoor distance could not explain the reduction of undershooting in absence of acoustic cues. Even if the role
played by distance estimation needs further studies, our results
seem in agreement with the idea that people were not able to
describe the environment scaling it in arbitrary, unspecied units
(even if commonly used, as meters). But they could be able to transform it into units related to intended actions, such as the number
of steps needed to travel a seen distance [30]. So, the memorized
distance can be evaluated in terms of number of steps needed to
achieve the target.
However, when the subjects were blindfolded, they performed
shorter steps than those performed with open eyes (especially
indoors). It implied that the number of steps needed to be
increased, as outdoor walkers did. Conversely, indoor walkers did
not change their number of steps in open vs closed eyes condition, in spite of their step length reduction when blindfolded.
Moreover, the number of steps was the only parameter that did
not vary indoors between different conditions (with and without
visual feedback and/or with and without acoustic feedback). Conversely, the other gait spatial parameters seemed to be affected
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