Linear and nonlinear analysis of postural control in frailty syndrome

Background: Adaptive postural control can be impaired in the presence of frailty syndrome, given that this condition causes homeostatic dysregulation in physiological systems.

Objectives: To compare the center of pressure (CoP) displacements of non-frail, pre-frail, and frail elderly subjects in the standing position before and after postural transition of sitting and rising from a chair, using linear and nonlinear methods.

Methods: Forty-two elderly subjects were divided into 3 groups: non-frail (n=15), pre-frail (n=15), and frail (n=12). The CoP displacements in the anteroposterior (AP) and mediolateral (ML) direction in the orthostatic position, 30s before and after sitting down and rising from a chair, were evaluated by means of linear measurements (root mean square (RMS), amplitude, and total average speed) and nonlinear measurements (corrected approximate entropy - CApEn), sample entropy (SampEn), and complexity index (CI) and its normalized versions.

Results: After sitting and rising, there was an increase in RMS in the ML direction in all groups and in the AP direction in the non-frail and frail groups. The frail group showed no reduction in entropy values in either direction, and the pre-frail group showed no reduction in the ML direction.

Conclusions: The results of this study indicate that, in the presence of frailty syndrome, the organization of CoP displacements does not show less regularity after sitting and rising from a chair, reflecting a possible impairment of the integration of the systems involved in postural control.