Measuring regularity of human postural sway using approximate entropy and sample entropy in patients with Ehlers-Danlos syndrome hypermobility type.

Ligament laxity in Ehlers-Danlos syndrome hypermobility type (EDS-HT) patients can influence the intrinsic information about posture and movement and can have a negative effect on the appropriateness of postural reactions. Several measures have been proposed in literature to describe the planar migration of CoP over the base of support, and the most used in clinical field are the CoP excursions in antero-posterior and medio-lateral direction. In recent years a growing number of studies have been designed to explore the complexity of the COP trajectories during quiet standing. We assessed 13 adults with EDS-HT (EDSG) and 20 healthy adults (CG) during static posture, evaluating the CoP using time and frequency domain analysis and entropy analysis (SampEn and ApEn parameters). Higher values of CoP displacements in medio-lateral and anterior-posterior directions for EDSG than CG were found; no differences were observed in CoP frequency. The entropy analysis showed lower value for EDSG than CG, pointing out the needing of EDSG to concentrate more attention on postural control, loosing complexity and reflecting a less automatized postural control.

[1]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[2]  F. Plum.  Handbook of Physiology. , 1960 .

[3]  A. Strang,et al.  Fatigue-induced adaptive changes of anticipatory postural adjustments , 2007, Experimental Brain Research.

[4]  M. Woollacott,et al.  Attention and the control of posture and gait: a review of an emerging area of research. , 2002, Gait & posture.

[5]  Luca Mainardi,et al.  Fractal dimension approach in postural control of subjects with Prader-Willi Syndrome , 2011, Journal of NeuroEngineering and Rehabilitation.

[6]  A. Nardone,et al.  Human stance stability improves with the repetition of the task: effect of foot position and visual condition , 1997, Neuroscience Letters.

[7]  V. Cimolin,et al.  The effect of vision on postural strategies in Prader-Willi patients. , 2011, Research in developmental disabilities.

[8]  A. Geurts,et al.  Dynamical structure of center-of-pressure trajectories in patients recovering from stroke , 2006, Experimental Brain Research.

[9]  G. Wnek,et al.  Encyclopedia of biomaterials and biomedical engineering , 2008 .

[10]  A. Cappello,et al.  Feature selection of stabilometric parameters based on principal component analysis , 2006, Medical and Biological Engineering and Computing.

[11]  Joshua L. Haworth,et al.  Structural changes in postural sway lend insight into effects of balance training, vision, and support surface on postural control in a healthy population , 2011, European Journal of Applied Physiology.

[12]  Manuela Galli,et al.  The effects of muscle hypotonia and weakness on balance: a study on Prader-Willi and Ehlers-Danlos syndrome patients. , 2011, Research in developmental disabilities.

[13]  P. Tsipouras,et al.  Orthopaedic Manifestations of Ehlers-Danlos Syndrome , 2000, Clinical orthopaedics and related research.

[14]  A Cappozzo,et al.  The sensitivity of posturographic parameters to acquisition settings. , 2002, Medical engineering & physics.

[15]  P. Beek,et al.  Sway regularity reflects attentional involvement in postural control: effects of expertise, vision and cognition. , 2009, Gait & posture.

[16]  P. Beek,et al.  Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children , 2007, Experimental Brain Research.

[17]  H. Bliddal,et al.  Postural sway in normal subjects aged 20–70 years , 2003, Clinical physiology and functional imaging.

[18]  N. Vuillerme,et al.  Effects of plantar-flexor muscle fatigue on the magnitude and regularity of center-of-pressure fluctuations , 2011, Experimental Brain Research.

[19]  P. Beighton,et al.  Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK). , 1998, American journal of medical genetics.

[20]  S. Pinnell,et al.  Ehlers-Danlos syndromes , 2019, British medical journal.

[21]  D. Heinegård,et al.  Glycosylated matrix protein , 2002 .

[22]  D. Cuesta-Frau,et al.  Characterization of Sample Entropy in the Context of Biomedical Signal Analysis , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[23]  R. Grahame,et al.  The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). , 2000, The Journal of rheumatology.

[24]  A. Strang,et al.  Fatigue-induced early onset of anticipatory postural adjustments in non-fatigued muscles: support for a centrally mediated adaptation , 2009, Experimental Brain Research.

[25]  Frédéric Bouchara,et al.  On the use of sample entropy to analyze human postural sway data. , 2009, Medical engineering & physics.

[26]  F. Horak,et al.  Postural Orientation and Equilibrium , 2011 .

[27]  S. Pincus,et al.  A recipe for randomness. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[28]  D. Sillence,et al.  The lack of clinical distinction between the hypermobility type of Ehlers–Danlos syndrome and the joint hypermobility syndrome (a.k.a. hypermobility syndrome) , 2009, American journal of medical genetics. Part A.

[29]  L. Mainardi,et al.  Postural control in patients with Down syndrome , 2008, Disability and rehabilitation.

[30]  Jeffrey M. Hausdorff,et al.  Fractal dynamics in physiology: Alterations with disease and aging , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[31]  A. Superti-Furga,et al.  The Ehlers‐Danlos Syndrome , 2003 .

[32]  Martin O. Mendez,et al.  Digital Biomedical Signal Acquisition and Processing: Basic Topics , 2006 .

[33]  N. Vuillerme,et al.  Center-of-pressure regularity as a marker for attentional investment in postural control: a comparison between sitting and standing postures. , 2011, Human movement science.

[34]  J. Richman,et al.  Physiological time-series analysis using approximate entropy and sample entropy. , 2000, American journal of physiology. Heart and circulatory physiology.

[35]  Melvyn Roerdink,et al.  Regularity of center-of-pressure trajectories depends on the amount of attention invested in postural control , 2007, Experimental Brain Research.

[36]  L. Mainardi,et al.  Postural analysis in time and frequency domains in patients with Ehlers-Danlos syndrome. , 2011, Research in developmental disabilities.