Skip to main content
Top
Published in: Journal of NeuroEngineering and Rehabilitation 1/2007

Open Access 01-12-2007 | Research

Fractal time series analysis of postural stability in elderly and control subjects

Authors: Hassan Amoud, Mohamed Abadi, David J Hewson, Valérie Michel-Pellegrino, Michel Doussot, Jacques Duchêne

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2007

Login to get access

Abstract

Background

The study of balance using stabilogram analysis is of particular interest in the study of falls. Although simple statistical parameters derived from the stabilogram have been shown to predict risk of falls, such measures offer little insight into the underlying control mechanisms responsible for degradation in balance. In contrast, fractal and non-linear time-series analysis of stabilograms, such as estimations of the Hurst exponent (H), may provide information related to the underlying motor control strategies governing postural stability. In order to be adapted for a home-based follow-up of balance, such methods need to be robust, regardless of the experimental protocol, while producing time-series that are as short as possible. The present study compares two methods of calculating H: Detrended Fluctuation Analysis (DFA) and Stabilogram Diffusion Analysis (SDA) for elderly and control subjects, as well as evaluating the effect of recording duration.

Methods

Centre of pressure signals were obtained from 90 young adult subjects and 10 elderly subjects. Data were sampled at 100 Hz for 30 s, including stepping onto and off the force plate. Estimations of H were made using sliding windows of 10, 5, and 2.5 s durations, with windows slid forward in 1-s increments. Multivariate analysis of variance was used to test for the effect of time, age and estimation method on the Hurst exponent, while the intra-class correlation coefficient (ICC) was used as a measure of reliability.

Results

Both SDA and DFA methods were able to identify differences in postural stability between control and elderly subjects for time series as short as 5 s, with ICC values as high as 0.75 for DFA.

Conclusion

Both methods would be well-suited to non-invasive longitudinal assessment of balance. In addition, reliable estimations of H were obtained from time series as short as 5 s.
Appendix
Available only for authorised users
Literature
1.
go back to reference Comité Français d'Education pour la Santé: Les clés du " bien vieillir " : prévention des chutes chez les seniors. Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés; 2001, 20. Comité Français d'Education pour la Santé: Les clés du " bien vieillir " : prévention des chutes chez les seniors. Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés; 2001, 20.
2.
go back to reference Brauer SG, Burns YR, Galley P: A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci 2000, 55: M469-476.CrossRefPubMed Brauer SG, Burns YR, Galley P: A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci 2000, 55: M469-476.CrossRefPubMed
3.
go back to reference Maki BE, Holliday PJ, Topper AK: A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994, 49: M72-84.CrossRefPubMed Maki BE, Holliday PJ, Topper AK: A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994, 49: M72-84.CrossRefPubMed
4.
go back to reference Raiche M, Hebert R, Prince F, Corriveau H: Screening older adults at risk of falling with the Tinetti balance scale. Lancet 2000, 356: 1001-1002. 10.1016/S0140-6736(00)02695-7CrossRefPubMed Raiche M, Hebert R, Prince F, Corriveau H: Screening older adults at risk of falling with the Tinetti balance scale. Lancet 2000, 356: 1001-1002. 10.1016/S0140-6736(00)02695-7CrossRefPubMed
5.
go back to reference Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P: Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001, 54: 837-844. 10.1016/S0895-4356(01)00349-3CrossRefPubMed Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P: Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001, 54: 837-844. 10.1016/S0895-4356(01)00349-3CrossRefPubMed
6.
go back to reference Rubenstein LZ, Josephson KR: The epidemiology of falls and syncope. Clin Geriatr Med 2002, 18: 141-158. 10.1016/S0749-0690(02)00002-2CrossRefPubMed Rubenstein LZ, Josephson KR: The epidemiology of falls and syncope. Clin Geriatr Med 2002, 18: 141-158. 10.1016/S0749-0690(02)00002-2CrossRefPubMed
7.
go back to reference Nevitt M, Cummings S, Kidd S, Black D: Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989, 261: 2663-2668. 10.1001/jama.261.18.2663CrossRefPubMed Nevitt M, Cummings S, Kidd S, Black D: Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989, 261: 2663-2668. 10.1001/jama.261.18.2663CrossRefPubMed
8.
go back to reference Vellas BJ, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Garry PJ: One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc 1997, 45: 735-738.CrossRefPubMed Vellas BJ, Wayne SJ, Romero L, Baumgartner RN, Rubenstein LZ, Garry PJ: One-leg balance is an important predictor of injurious falls in older persons. J Am Geriatr Soc 1997, 45: 735-738.CrossRefPubMed
9.
go back to reference Wood BH, Bilclough JA, Bowron A, Walker RW: Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry 2002, 72: 721-725. 10.1136/jnnp.72.6.721PubMedCentralCrossRefPubMed Wood BH, Bilclough JA, Bowron A, Walker RW: Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry 2002, 72: 721-725. 10.1136/jnnp.72.6.721PubMedCentralCrossRefPubMed
10.
go back to reference Allum JH, Bloem BR, Carpenter MG, Honegger F: Differential diagnosis of proprioceptive and vestibular deficits using dynamic support-surface posturography. Gait Posture 2001, 14: 217-226. 10.1016/S0966-6362(01)00142-4CrossRefPubMed Allum JH, Bloem BR, Carpenter MG, Honegger F: Differential diagnosis of proprioceptive and vestibular deficits using dynamic support-surface posturography. Gait Posture 2001, 14: 217-226. 10.1016/S0966-6362(01)00142-4CrossRefPubMed
11.
go back to reference Gill J, Allum JH, Carpenter MG, Held-Ziolkowska M, Adkin AL, Honegger F, Pierchala K: Trunk sway measures of postural stability during clinical balance tests: effects of age. J Gerontol A Biol Sci Med Sci 2001, 56: M438-447.CrossRefPubMed Gill J, Allum JH, Carpenter MG, Held-Ziolkowska M, Adkin AL, Honegger F, Pierchala K: Trunk sway measures of postural stability during clinical balance tests: effects of age. J Gerontol A Biol Sci Med Sci 2001, 56: M438-447.CrossRefPubMed
12.
go back to reference Lord SR, Menz HB: Visual contributions to postural stability in older adults. Gerontology 2000, 46: 306-310. 10.1159/000022182CrossRefPubMed Lord SR, Menz HB: Visual contributions to postural stability in older adults. Gerontology 2000, 46: 306-310. 10.1159/000022182CrossRefPubMed
13.
go back to reference Mathias S, Nayak U, Isaacs B: Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil 1986, 67: 387-389.PubMed Mathias S, Nayak U, Isaacs B: Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil 1986, 67: 387-389.PubMed
14.
go back to reference Shumway-Cook A, Baldwin M, Polissar NL, Gruber W: Predicting the probability for falls in community-dwelling older adults. Phys Ther 1997, 77: 812-819.PubMed Shumway-Cook A, Baldwin M, Polissar NL, Gruber W: Predicting the probability for falls in community-dwelling older adults. Phys Ther 1997, 77: 812-819.PubMed
15.
go back to reference Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319: 1701-1707.CrossRefPubMed Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319: 1701-1707.CrossRefPubMed
16.
go back to reference Lord S, Clark R, Webster I: Postural stability and associated physiological factors in a population of aged persons. J Gerontol 1991, 46: M69-76.CrossRefPubMed Lord S, Clark R, Webster I: Postural stability and associated physiological factors in a population of aged persons. J Gerontol 1991, 46: M69-76.CrossRefPubMed
17.
go back to reference Murray MP, Seireg AA, Sepic SB: Normal postural stability and steadiness: quantitative assessment. J Bone Joint Surg Am 1975, 57: 510-516.PubMed Murray MP, Seireg AA, Sepic SB: Normal postural stability and steadiness: quantitative assessment. J Bone Joint Surg Am 1975, 57: 510-516.PubMed
18.
go back to reference Thapa PB, Gideon P, Brockman KG, Fought RL, Ray WA: Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents. J Gerontol A Biol Sci Med Sci 1996, 51: M239-246.CrossRefPubMed Thapa PB, Gideon P, Brockman KG, Fought RL, Ray WA: Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents. J Gerontol A Biol Sci Med Sci 1996, 51: M239-246.CrossRefPubMed
19.
go back to reference Doussot M, Hewson D, Duchêne J: A remote monitoring system for assessing balance quality. 3rd European Medical and Biological Engineering Conference (EMBEC): Advancement of Medicine and Health Care through Technology; 20–25 November 2005. Doussot M, Hewson D, Duchêne J: A remote monitoring system for assessing balance quality. 3rd European Medical and Biological Engineering Conference (EMBEC): Advancement of Medicine and Health Care through Technology; 20–25 November 2005.
20.
go back to reference Collins JJ, De Luca CJ: Upright, correlated random walks: A statistical-biomechanics approach to the human postural control system. Chaos 1995, 5: 57-63. 10.1063/1.166086CrossRefPubMed Collins JJ, De Luca CJ: Upright, correlated random walks: A statistical-biomechanics approach to the human postural control system. Chaos 1995, 5: 57-63. 10.1063/1.166086CrossRefPubMed
21.
go back to reference Riley MA, Wong S, Mitra S, Turvey MT: Common effects of touch and vision on postural parameters. Exp Brain Res 1997, 117: 165-170. 10.1007/s002210050211CrossRefPubMed Riley MA, Wong S, Mitra S, Turvey MT: Common effects of touch and vision on postural parameters. Exp Brain Res 1997, 117: 165-170. 10.1007/s002210050211CrossRefPubMed
22.
go back to reference Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC, Phillips E, Lipsitz LA, Collins JJ: Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait Posture 2003, 18: 101-108. 10.1016/S0966-6362(02)00200-XCrossRefPubMed Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC, Phillips E, Lipsitz LA, Collins JJ: Aging, muscle activity, and balance control: physiologic changes associated with balance impairment. Gait Posture 2003, 18: 101-108. 10.1016/S0966-6362(02)00200-XCrossRefPubMed
23.
go back to reference Delignières D, Deschamps T, Legros A, Caillou N: A methodological note on nonlinear time series analysis: is the open- and closed-loop model of Collins and De Luca (1993) a statistical artifact? J Mot Behav 2003, 35: 86-97.CrossRefPubMed Delignières D, Deschamps T, Legros A, Caillou N: A methodological note on nonlinear time series analysis: is the open- and closed-loop model of Collins and De Luca (1993) a statistical artifact? J Mot Behav 2003, 35: 86-97.CrossRefPubMed
24.
go back to reference Duarte M, Zatsiorsky VM: Long-range correlations in human standing. Physics Letters A 2001, 283: 124-128. 10.1016/S0375-9601(01)00188-8CrossRef Duarte M, Zatsiorsky VM: Long-range correlations in human standing. Physics Letters A 2001, 283: 124-128. 10.1016/S0375-9601(01)00188-8CrossRef
25.
go back to reference Carroll JP, Freedman W: Nonstationary properties of postural sway. J Biomech 1993, 26: 409-416. 10.1016/0021-9290(93)90004-XCrossRefPubMed Carroll JP, Freedman W: Nonstationary properties of postural sway. J Biomech 1993, 26: 409-416. 10.1016/0021-9290(93)90004-XCrossRefPubMed
26.
go back to reference Harris GF, Riedel SA, Matesi D, Smith P: Standing postural stability assessment and signal stationarity inchildren with cerebral palsy. IEEE Transactions on Rehabilitation Engineering 1993, 1: 35-42. 10.1109/86.242406CrossRef Harris GF, Riedel SA, Matesi D, Smith P: Standing postural stability assessment and signal stationarity inchildren with cerebral palsy. IEEE Transactions on Rehabilitation Engineering 1993, 1: 35-42. 10.1109/86.242406CrossRef
27.
go back to reference Peterka RJ: Postural control model interpretation of stabilogram diffusion analysis. Biol Cybern 2000, 82: 335-343. 10.1007/s004220050587CrossRefPubMed Peterka RJ: Postural control model interpretation of stabilogram diffusion analysis. Biol Cybern 2000, 82: 335-343. 10.1007/s004220050587CrossRefPubMed
28.
go back to reference Mandelbrot B, Van Ness J: Fractional brownian motion, fractional noses and applications. SIAM Review 1968, 10: 422-437. 10.1137/1010093CrossRef Mandelbrot B, Van Ness J: Fractional brownian motion, fractional noses and applications. SIAM Review 1968, 10: 422-437. 10.1137/1010093CrossRef
29.
go back to reference Collins JJ, De Luca CJ, Burrows A, Lipsitz LA: Age-related changes in open-loop and closed-loop postural control mechanisms. Exp Brain Res 1995, 104: 480-492. 10.1007/BF00231982CrossRefPubMed Collins JJ, De Luca CJ, Burrows A, Lipsitz LA: Age-related changes in open-loop and closed-loop postural control mechanisms. Exp Brain Res 1995, 104: 480-492. 10.1007/BF00231982CrossRefPubMed
30.
go back to reference Collins JJ, De Luca CJ: Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 1993, 95: 308-318. 10.1007/BF00229788CrossRefPubMed Collins JJ, De Luca CJ: Open-loop and closed-loop control of posture: a random-walk analysis of center-of-pressure trajectories. Exp Brain Res 1993, 95: 308-318. 10.1007/BF00229788CrossRefPubMed
31.
go back to reference Kantz H, Schreiber T: Nonlinear time series analysis. 2nd edition. Cambridge, UK: Cambridge University Press; 2004. Kantz H, Schreiber T: Nonlinear time series analysis. 2nd edition. Cambridge, UK: Cambridge University Press; 2004.
32.
go back to reference Eke A, Herman P, Kocsis L, Kozak L: Fractal characterization of complexity in temporal physiological signals. Physiol Meas 2002, 23: R1-38. 10.1088/0967-3334/23/1/201CrossRefPubMed Eke A, Herman P, Kocsis L, Kozak L: Fractal characterization of complexity in temporal physiological signals. Physiol Meas 2002, 23: R1-38. 10.1088/0967-3334/23/1/201CrossRefPubMed
34.
go back to reference Peng CK, Havlin S, Stanley HE, Goldberger AL: Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 1995, 5: 82-87. 10.1063/1.166141CrossRefPubMed Peng CK, Havlin S, Stanley HE, Goldberger AL: Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. Chaos 1995, 5: 82-87. 10.1063/1.166141CrossRefPubMed
35.
go back to reference Tabachnick BG, Fidell LS: Using multivariate statistics. 4th edition. Needham Heights, MA, USA: Allyn and Bacon; 2001. Tabachnick BG, Fidell LS: Using multivariate statistics. 4th edition. Needham Heights, MA, USA: Allyn and Bacon; 2001.
36.
go back to reference Shrout PE, Fleiss JL: Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979, 2: 420-428. 10.1037/0033-2909.86.2.420CrossRef Shrout PE, Fleiss JL: Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979, 2: 420-428. 10.1037/0033-2909.86.2.420CrossRef
37.
go back to reference Hopkins W: Measures of reliability in sports medicine and science. Sports Med 2000, 30: 1-15. 10.2165/00007256-200030010-00001CrossRefPubMed Hopkins W: Measures of reliability in sports medicine and science. Sports Med 2000, 30: 1-15. 10.2165/00007256-200030010-00001CrossRefPubMed
38.
go back to reference Goldberger AL, Amaral LA, Hausdorff JM, Ivanov P, Peng CK, Stanley HE: Fractal dynamics in physiology: alterations with disease and aging. Proc Natl Acad Sci USA 2002,99(Suppl 1):2466-2472. 10.1073/pnas.012579499PubMedCentralCrossRefPubMed Goldberger AL, Amaral LA, Hausdorff JM, Ivanov P, Peng CK, Stanley HE: Fractal dynamics in physiology: alterations with disease and aging. Proc Natl Acad Sci USA 2002,99(Suppl 1):2466-2472. 10.1073/pnas.012579499PubMedCentralCrossRefPubMed
39.
go back to reference Eke A, Herman P, Bassingthwaighte JB, Raymond GM, Percival DB, Cannon M, Balla I, Ikrenyi C: Physiological time series: distinguishing fractal noises from motions. Pflugers Arch 2000, 439: 403-415. 10.1007/s004240050957CrossRefPubMed Eke A, Herman P, Bassingthwaighte JB, Raymond GM, Percival DB, Cannon M, Balla I, Ikrenyi C: Physiological time series: distinguishing fractal noises from motions. Pflugers Arch 2000, 439: 403-415. 10.1007/s004240050957CrossRefPubMed
40.
go back to reference Delignières D, Torre K, Lemoine L: Methodological issues in the application of monofractal analyses in psychological and behavioral research. Nonlinear Dynamics in Psychology and Life Science 2005, in press. Delignières D, Torre K, Lemoine L: Methodological issues in the application of monofractal analyses in psychological and behavioral research. Nonlinear Dynamics in Psychology and Life Science 2005, in press.
41.
go back to reference Fleiss JL: The design and analysis of clinical experiments. New York: Wiley; 1986. Fleiss JL: The design and analysis of clinical experiments. New York: Wiley; 1986.
42.
go back to reference Karen W Hayes MEJ: Measures of adult general performance tests: The Berg Balance Scale, Dynamic Gait Index (DGI), Gait Velocity, Physical Performance Test (PPT), Timed Chair Stand Test, Timed Up and Go, and Tinetti Performance-Oriented Mobility Assessment (POMA). Arthritis Care & Research 2003, 49: S28-S42. 10.1002/art.11411CrossRef Karen W Hayes MEJ: Measures of adult general performance tests: The Berg Balance Scale, Dynamic Gait Index (DGI), Gait Velocity, Physical Performance Test (PPT), Timed Chair Stand Test, Timed Up and Go, and Tinetti Performance-Oriented Mobility Assessment (POMA). Arthritis Care & Research 2003, 49: S28-S42. 10.1002/art.11411CrossRef
43.
go back to reference Chiari L, Cappello A, Lenzi D, Della Croce U: An improved technique for the extraction of stochastic parameters from stabilograms. Gait Posture 2000, 12: 225-234. 10.1016/S0966-6362(00)00086-2CrossRefPubMed Chiari L, Cappello A, Lenzi D, Della Croce U: An improved technique for the extraction of stochastic parameters from stabilograms. Gait Posture 2000, 12: 225-234. 10.1016/S0966-6362(00)00086-2CrossRefPubMed
44.
go back to reference Norris JA, Marsh AP, Smith IJ, Kohut RI, Miller ME: Ability of static and statistical mechanics posturographic measures to distinguish between age and fall risk. J Biomech 2005, 38: 1263-1272. 10.1016/j.jbiomech.2004.06.014CrossRefPubMed Norris JA, Marsh AP, Smith IJ, Kohut RI, Miller ME: Ability of static and statistical mechanics posturographic measures to distinguish between age and fall risk. J Biomech 2005, 38: 1263-1272. 10.1016/j.jbiomech.2004.06.014CrossRefPubMed
Metadata
Title
Fractal time series analysis of postural stability in elderly and control subjects
Authors
Hassan Amoud
Mohamed Abadi
David J Hewson
Valérie Michel-Pellegrino
Michel Doussot
Jacques Duchêne
Publication date
01-12-2007
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2007
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-4-12

Other articles of this Issue 1/2007

Journal of NeuroEngineering and Rehabilitation 1/2007 Go to the issue