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Recurrence Quantification Analysis of Human Postural Fluctuations in Older Fallers and Non-fallers

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Abstract

We investigate postural sway data dynamics in older adult fallers and non-fallers. Center of pressure (COP) signals were recorded during quiet standing in 28 older adults. The subjects were divided in two groups: with and without history of falls. COP time series were analyzed using recurrence quantification analysis (RQA) in both anteroposterior and mediolateral (ML) directions. Classical stabilometric variables (path length and range) were also computed. The results showed that RQA outputs quantifying predictability of COP fluctuations and Shannon entropy of recurrence plot diagonal line length distribution, were significantly higher in fallers, only for ML direction. In addition, the range of ML COP signals was also significantly higher in fallers. This result is in accordance with some findings of the literature and could be interpreted as an increased hip strategy in fallers. The RQA results seem coherent with the theory of loss of complexity with aging and disease. Our results suggest that RQA is a promising approach for the investigation of COP fluctuations in a frail population.

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Acknowledgments

This study was supported by a grant from the French Ministry of Health (PHRC Interrégional 2010, A00564-35). The sponsor had no role in the study. The authors would like to thank the anonymous reviewers for their valuable comments and suggestions.

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There are no conflicts of interest relating to this manuscript.

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Authors and Affiliations

  1. Movement to Health Laboratory, EuroMov, Montpellier-1 University, 700, Av. du Pic St Loup, 34090, Montpellier, France

    Sofiane Ramdani, Guillaume Tallon, Pierre Louis Bernard & Hubert Blain

  2. Department of Geriatrics, University Hospital of Montpellier, Montpellier, France

    Guillaume Tallon & Hubert Blain

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  1. Sofiane Ramdani
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Correspondence to Sofiane Ramdani.

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Appendices

Appendix A

We present here the RQA results for the comparison between the two groups with two different values of the radius: 25% and 35% of mean distance, respectively in Tables 4 and 5. All other parameters were set to the selected values (m = 8, τ = 6 and l min = 4).

Table 4 Statistical results of the comparison between the two groups for RQA measures computed with a radius \(\varepsilon = 25\%\) of mean of all distances
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Table 5 Statistical results of the comparison between the two groups for RQA measures computed with a radius \(\varepsilon = 35\%\) of mean of all distances
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Appendix B

We present here the MSE analysis results for the comparison between the two groups. The MSE computations were conducted according to the procedure described in Costa et al. 17 Prior to SampEn calculations, the recorded COP time series were detrended by means of Empirical Mode Decomposition (EMD).23,31 EMD is an adaptative (data-driven) technique which decomposes the signal as the sum of components called intrinsic mode functions (IMFs).31 The detrending is basically performed by removing the higher order (low-frequency) IMFs of the original signal. A global index of complexity C I was calculated by summing the SampEn values over a predefined range of scales. We used six scales. A dimension of 2 and a normalized radius of 0.15 were used for SampEn computations. Tables 6 shows the results of the comparisons between non-fallers and fallers in AP and ML directions.

Table 6 Statistical results of the comparison between the two groups for the complexity index C I provided by MSE in AP and ML directions
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Ramdani, S., Tallon, G., Bernard, P.L. et al. Recurrence Quantification Analysis of Human Postural Fluctuations in Older Fallers and Non-fallers. Ann Biomed Eng 41, 1713–1725 (2013). https://doi.org/10.1007/s10439-013-0790-x

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