The ability to move in any direction is how these treadmills differ from their basic counterparts (that permit only unidirectional locomotion).
The second approach employs a harness for tracking, and optionally provides whole-body force feedback.
The system must recognize this using a variety of sensing means, and gently accelerate the user back towards the center.
Keeping the forces that return the user to center below the human sensing threshold is the main challenge with these systems.
In such a setup, the mechanism for one axis would lay within the other, the belts typically being replaced with something akin to a wire ladder, and studs being used on footwear.